Provider Demographics
NPI:1942418546
Name:JOHN T. MORRIS, III, MD, PC
Entity Type:Organization
Organization Name:JOHN T. MORRIS, III, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:901-288-6255
Mailing Address - Street 1:780 TRUSE PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-5361
Mailing Address - Country:US
Mailing Address - Phone:901-288-6255
Mailing Address - Fax:901-763-3435
Practice Address - Street 1:780 TRUSE PKWY STE 102
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-5361
Practice Address - Country:US
Practice Address - Phone:901-288-6255
Practice Address - Fax:901-757-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29278207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00077071OtherRAILROAD MEDICARE
TN38157222Medicaid
MS1623078Medicaid
AR132825001Medicaid
MO208875518Medicaid
MS1623078Medicaid
TN38157222Medicaid
MS390000301Medicare PIN