Provider Demographics
NPI:1952315558
Name:MORRIS, DALE (OD)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 KATHERINE LEE BATES RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2877
Mailing Address - Country:US
Mailing Address - Phone:508-548-1135
Mailing Address - Fax:508-548-1823
Practice Address - Street 1:160 KATHERINE LEE BATES RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2877
Practice Address - Country:US
Practice Address - Phone:508-548-1135
Practice Address - Fax:508-548-1823
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3856152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA665889OtherTUFTS
MA0392359Medicaid
MA1431005OtherUHC
MA153298OtherHPHC
3026701OtherAETNA
MA0018403OtherNHP
MAW15987OtherBCBS
MAW15987OtherBCBS
MA1431005OtherUHC