Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 38252 | TN |
Y | 2084N0402X | Child Neurologist | 63922 | GA |
NPI | 1124024849 |
---|---|
Provider Name | Dr. Eugene Brannon Morris III |
First Address | Athens, GA 30606-6316 |
Second Address | Athens, GA 30606-6316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 22/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009998455 | (05) | AL |
010210712 | (05) | VA |
0149583 | (05) | MT |
03058877 | (05) | MS |
158894001 | (05) | AR |
1628883 | (05) | LA |
176786501 | (05) | TX |
200056700A | (05) | OK |
200520170A | (05) | IN |
207281007 | (05) | MO |
422400000 | (05) | ME |
5440557 | (05) | TN |
64100639 | (05) | KY |
H35896 | (02) | TN |