Provider Demographics
NPI:1023099165
Name:MORRISON, JOHN GORDON (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GORDON
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-333-1259
Mailing Address - Fax:704-333-0371
Practice Address - Street 1:2015 RANDOLPH RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1200
Practice Address - Country:US
Practice Address - Phone:704-333-1259
Practice Address - Fax:704-333-0371
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC35444208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8961029Medicaid
NC2176819Medicare PIN
NCH83559Medicare UPIN