Provider Demographics
NPI:1205425105
Name:NORRIS, MORGAN TEW
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:TEW
Last Name:NORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2736 CLAUD FLEAHOP RD
Mailing Address - Street 2:
Mailing Address - City:ECLECTIC
Mailing Address - State:AL
Mailing Address - Zip Code:36024-7011
Mailing Address - Country:US
Mailing Address - Phone:334-399-3742
Mailing Address - Fax:
Practice Address - Street 1:2736 CLAUD FLEAHOP RD
Practice Address - Street 2:
Practice Address - City:ECLECTIC
Practice Address - State:AL
Practice Address - Zip Code:36024-7011
Practice Address - Country:US
Practice Address - Phone:334-399-3742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program