Provider Demographics
NPI:1942255682
Name:MORRIS, ELLIOT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:M
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 MOUNTAIN VIEW AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3178
Mailing Address - Country:US
Mailing Address - Phone:720-652-8650
Mailing Address - Fax:720-652-8655
Practice Address - Street 1:2030 MOUNTAIN VIEW AVE
Practice Address - Street 2:STE 300
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3178
Practice Address - Country:US
Practice Address - Phone:720-652-8650
Practice Address - Fax:720-652-8655
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6420207RG0100X
CO55808207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0081705Medicaid
CO22870059Medicaid
E28043Medicare UPIN
MT000009794Medicare ID - Type Unspecified
MT0081705Medicaid