Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | DO0000000656 | TN |
NPI | 1629012554 |
---|---|
Provider Name | Philip H Morson |
First Address | Bolivar, TN 38008-1554 |
Second Address | Bolivar, TN 38008-1554 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 12/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B04894 | (02) | TN |