Provider Demographics
NPI:1336338037
Name:L L MORRIS MD INC
Entity Type:Organization
Organization Name:L L MORRIS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-599-0045
Mailing Address - Street 1:212 IRVING AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-2282
Mailing Address - Country:US
Mailing Address - Phone:937-599-0045
Mailing Address - Fax:937-599-5209
Practice Address - Street 1:212 IRVING AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-2282
Practice Address - Country:US
Practice Address - Phone:937-599-0045
Practice Address - Fax:937-599-5209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH038166208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0282180Medicaid
OHA75341Medicare UPIN
OH9343581Medicare PIN