Provider Demographics
NPI:1205917077
Name:MORRIS, JOHN GLENN JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GLENN
Last Name:MORRIS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-273-7526
Mailing Address - Fax:352-273-6890
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-7526
Practice Address - Fax:352-273-6890
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD29678207RI0200X
FLME100291207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD39903302OtherBC/BS
FL279935900Medicaid
MD365561000Medicaid
E13663Medicare UPIN
MD39903302OtherBC/BS
FLAH584ZMedicare PIN