Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 08001243A | IN |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 08001243A | IN |
NPI | 1447233044 |
---|---|
Provider Name | Dr. Kirk D. Morrison |
First Address | Clarksville, IN 47129-1723 |
Second Address | Clarksville, IN 47129-1723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 18/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000042675 | ANTHEM BC/BS (01) | IN |
100076550A | (05) | IN |
214844100 | ACS (01) | IN |
350034998 | RRMR (01) | IN |
351955373100 | CARESOURCE (01) | IN |
U29010 | (02) | IN |