Provider Demographics
NPI:1215946686
Name:MORRIS, TERRY L (DO)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:L
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1525 MADISON ST STE 2
Mailing Address - Street 2:
Mailing Address - City:FREDONIA
Mailing Address - State:KS
Mailing Address - Zip Code:66736-1704
Mailing Address - Country:US
Mailing Address - Phone:620-378-2068
Mailing Address - Fax:620-378-2312
Practice Address - Street 1:1525 MADISON ST STE 2
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:KS
Practice Address - Zip Code:66736-1704
Practice Address - Country:US
Practice Address - Phone:620-378-2068
Practice Address - Fax:620-378-2312
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS515331208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSAN5571092OtherDEA
KSH57115Medicare UPIN