Provider Demographics
NPI:1851314603
Name:MORRIS, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4770 BASELINE RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2666
Mailing Address - Country:US
Mailing Address - Phone:720-304-0083
Mailing Address - Fax:720-304-0114
Practice Address - Street 1:4770 BASELINE RD
Practice Address - Street 2:SUITE 310
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2666
Practice Address - Country:US
Practice Address - Phone:720-304-0083
Practice Address - Fax:720-304-0114
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO431212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC19622Medicare UPIN