Provider Demographics
NPI:1982261202
Name:MORRIS, JOSHUA RYAN (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:RYAN
Last Name:MORRIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 GATEWAY CIR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8650
Mailing Address - Country:US
Mailing Address - Phone:614-274-2020
Mailing Address - Fax:614-272-8059
Practice Address - Street 1:6441 WINCHESTER BLVD STE E
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-2033
Practice Address - Country:US
Practice Address - Phone:614-274-2020
Practice Address - Fax:614-834-1339
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.006770152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1083795892Medicaid
OH1669650990Medicaid