Provider Demographics
NPI:1396765095
Name:MORRIS, PAUL (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 SAM PHILLIPS ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5859
Mailing Address - Country:US
Mailing Address - Phone:256-415-8567
Mailing Address - Fax:256-284-7797
Practice Address - Street 1:620 SAM PHILLIPS ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5859
Practice Address - Country:US
Practice Address - Phone:256-415-8567
Practice Address - Fax:256-284-7797
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07842300207R00000X, 207RC0000X
ALDO.1143207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALI49690Medicare UPIN
NJI49690Medicare UPIN
ALI49690Medicare UPIN