Basic Information
| Provider Information | |||||||||
| NPI: | 1073072740 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORRIS | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | CHARLES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9411 N OAK TRFY | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641552233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8164688632 | ||||||||
| FaxNumber: | 8164687722 | ||||||||
| Practice Location | |||||||||
| Address1: | 9411 N OAK TRFY | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641552233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8164688632 | ||||||||
| FaxNumber: | 8164687722 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2019 | ||||||||
| LastUpdateDate: | 03/13/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246ZC0007X | 19-161 | MO | Y | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Certified First Assistant |
No ID Information.