Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 38868 | MN |
N | 207QS0010X | Family Doctor - Sports Medicine | 38868 | MN |
NPI | 1033288584 |
---|---|
Provider Name | Dr. George A. Morris |
First Address | St Joseph, MN 56374-4106 |
Second Address | St Joseph, MN 56374-4106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 02/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
140339700 | (05) | MN |
G39745 | (02) |