Provider Demographics
NPI:1851624720
Name:ROBERT T MORRISON MD LLC
Entity Type:Organization
Organization Name:ROBERT T MORRISON MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LACIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:937-376-2571
Mailing Address - Street 1:215 S. ALLISON AVE.
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385
Mailing Address - Country:US
Mailing Address - Phone:937-376-2571
Mailing Address - Fax:937-376-2930
Practice Address - Street 1:215 S. ALLISON AVE.
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385
Practice Address - Country:US
Practice Address - Phone:937-376-2571
Practice Address - Fax:937-376-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-10
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3145224Medicaid