Provider Demographics
NPI:1841054657
Name:MORRISON, CHARLES A
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:A
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 1:364 PARRISH RUN RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26571-8097
Mailing Address - Country:US
Mailing Address - Phone:304-287-2122
Mailing Address - Fax:
Practice Address - Street 1:364 PARRISH RUN RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:WV
Practice Address - Zip Code:26571-8097
Practice Address - Country:US
Practice Address - Phone:304-287-2122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker