Provider Demographics
NPI:1265597397
Name:MORROW, LAVERT (MD)
Entity type:Individual
Prefix:
First Name:LAVERT
Middle Name:
Last Name:MORROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7451A N LINDBERGH BLVD
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-2120
Mailing Address - Country:US
Mailing Address - Phone:314-921-2950
Mailing Address - Fax:314-921-2943
Practice Address - Street 1:7451A N LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-2120
Practice Address - Country:US
Practice Address - Phone:314-921-2950
Practice Address - Fax:314-921-2943
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8378207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201251253Medicaid
MO201251253Medicaid
A29060Medicare UPIN