Provider Demographics
NPI:1881693141
Name:MORRIS, GARY D (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:D
Last Name:MORRIS
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 1:7195 ADVANCED WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3691
Mailing Address - Country:US
Mailing Address - Phone:702-740-5327
Mailing Address - Fax:702-740-5328
Practice Address - Street 1:7195 ADVANCED WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3691
Practice Address - Country:US
Practice Address - Phone:702-740-5327
Practice Address - Fax:702-740-5328
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9392207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV20-18510Medicaid
33873Medicare ID - Type Unspecified
H25998Medicare UPIN