Provider Demographics
NPI:1316909294
Name:MORRISON, RICHARD KEITH
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:KEITH
Last Name:MORRISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5964 WENTWORTH CIR S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-1839
Mailing Address - Country:US
Mailing Address - Phone:757-375-5204
Mailing Address - Fax:
Practice Address - Street 1:USS UNDERWOOD
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AA
Practice Address - Zip Code:34093-1491
Practice Address - Country:US
Practice Address - Phone:757-375-5204
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman