Provider Demographics
NPI:1669745741
Name:MORRIS, DEWARD LAWAYNE (BC-HIS)
Entity type:Individual
Prefix:
First Name:DEWARD
Middle Name:LAWAYNE
Last Name:MORRIS
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:WAYNE
Other - Middle Name:
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2900 W 3RD ST
Mailing Address - Street 2:BOX 451
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73644-4324
Mailing Address - Country:US
Mailing Address - Phone:580-243-0939
Mailing Address - Fax:580-243-0939
Practice Address - Street 1:2900 W 3RD ST
Practice Address - Street 2:BOX 451
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-4324
Practice Address - Country:US
Practice Address - Phone:580-243-0939
Practice Address - Fax:580-243-0939
Is Sole Proprietor?:No
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK864237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist