Provider Demographics
NPI:1215754452
Name:MORRISON, ELISHA AUSTIN
Entity type:Individual
Prefix:
First Name:ELISHA
Middle Name:AUSTIN
Last Name:MORRISON
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 1:236 KIMBALL COVE RD
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TN
Mailing Address - Zip Code:37347-5621
Mailing Address - Country:US
Mailing Address - Phone:423-838-8692
Mailing Address - Fax:
Practice Address - Street 1:518 OAK ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-1905
Practice Address - Country:US
Practice Address - Phone:423-425-4644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program