Provider Demographics
NPI:1811077910
Name:MORRISTOWN MD INC
Entity type:Organization
Organization Name:MORRISTOWN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-587-2271
Mailing Address - Street 1:1907 W MORRIS BLVD
Mailing Address - Street 2:SUITE A100
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-3860
Mailing Address - Country:US
Mailing Address - Phone:423-587-2271
Mailing Address - Fax:423-587-6412
Practice Address - Street 1:1907 W MORRIS BLVD
Practice Address - Street 2:SUITE A100
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-3860
Practice Address - Country:US
Practice Address - Phone:423-587-2271
Practice Address - Fax:423-587-6412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center