Provider Demographics
NPI:1306317565
Name:MORRIS, DONITA RENEE (RT (R))
Entity type:Individual
Prefix:
First Name:DONITA
Middle Name:RENEE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:RT (R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 N OXFORD ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-2255
Mailing Address - Country:US
Mailing Address - Phone:317-413-3731
Mailing Address - Fax:
Practice Address - Street 1:6910 N OXFORD ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-2255
Practice Address - Country:US
Practice Address - Phone:317-413-3731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INXT0167462085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology