Provider Demographics
NPI:1851407910
Name:MORRIS, JOSEPH DEAN (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DEAN
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 MADISON ST
Mailing Address - Street 2:PO BOX 1128
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-5227
Mailing Address - Country:US
Mailing Address - Phone:573-635-7651
Mailing Address - Fax:573-659-4515
Practice Address - Street 1:1125 MADISON ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-5227
Practice Address - Country:US
Practice Address - Phone:573-635-7651
Practice Address - Fax:573-659-4515
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR86382084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO05-04001OtherUNITED HEALTH CARE
MOCR039OtherMERCY HEALTH PLANS
MO105923001OtherBC/BS OF MISSOURI
MO240869719Medicaid
MS25888OtherBLUE CHOICE
MO4504305OtherAETNA INSURANCE
MO110044188OtherRR MEDICARE
MO13043OtherGROUP HEALTH PLANS
MO119192OtherHEALTHLINK
MO240869719Medicaid
MO000003073Medicare ID - Type Unspecified