Basic Information
| Provider Information | |||||||||
| NPI: | 1619947991 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORRIS | ||||||||
| FirstName: | DELL | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1735 N STATE ST | ||||||||
| Address2: | |||||||||
| City: | PROVO | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846041010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013741818 | ||||||||
| FaxNumber: | 8013741826 | ||||||||
| Practice Location | |||||||||
| Address1: | 1735 N STATE ST | ||||||||
| Address2: | |||||||||
| City: | PROVO | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846041010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013741818 | ||||||||
| FaxNumber: | 8013792959 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2006 | ||||||||
| LastUpdateDate: | 07/12/2008 | ||||||||
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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 | 152W00000X | 3270569934 | UT | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 64757 | 01 | UT | PEHP | OTHER | 208819 | 01 | UT | ALTIUS | OTHER | 87028357684604A001 | 01 | UT | TRICARE | OTHER | 107002178102 | 01 | UT | SELECT HEALTH | OTHER | 410045092 | 01 | UT | UNITED HEALTHCARE | OTHER | 297186 | 01 | UT | DMBA | OTHER | 870283576MO1 | 01 | UT | EMIA | OTHER |