Provider Demographics
NPI:1881839041
Name:MORRIS, LISA M (MD)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:M
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5089 S. 900 E.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5731
Mailing Address - Country:US
Mailing Address - Phone:801-743-0700
Mailing Address - Fax:801-743-0701
Practice Address - Street 1:5089 S. 900 E.
Practice Address - Street 2:SUITE 100
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-5731
Practice Address - Country:US
Practice Address - Phone:801-743-0700
Practice Address - Fax:801-743-0701
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY264512-1207Y00000X
LA325607207Y00000X
UT8598444-12052086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology