Provider Demographics
NPI:1205297181
Name:MORRIS, MAX
Entity type:Individual
Prefix:DR
First Name:MAX
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 MAGNOLIA ST S
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:AL
Mailing Address - Zip Code:35096-6102
Mailing Address - Country:US
Mailing Address - Phone:205-763-7759
Mailing Address - Fax:205-763-2131
Practice Address - Street 1:99 MAGNOLIA ST S
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:AL
Practice Address - Zip Code:35096-6102
Practice Address - Country:US
Practice Address - Phone:205-763-7759
Practice Address - Fax:205-763-2131
Is Sole Proprietor?:No
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16484183500000X
KS114593183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist