Provider Demographics
NPI:1063602837
Name:MORRISON, MARIE J (MD)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:J
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 754
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37822-0754
Mailing Address - Country:US
Mailing Address - Phone:423-623-0233
Mailing Address - Fax:423-623-8311
Practice Address - Street 1:222 HERITAGE BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-4200
Practice Address - Country:US
Practice Address - Phone:423-623-0233
Practice Address - Fax:423-623-8311
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1505904Medicaid