Provider Demographics
NPI:1699870048
Name:JIMMY J. MORRISON, MD, PA
Entity type:Organization
Organization Name:JIMMY J. MORRISON, MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-236-2364
Mailing Address - Street 1:813 LINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-4853
Mailing Address - Country:US
Mailing Address - Phone:870-236-2364
Mailing Address - Fax:870-236-2634
Practice Address - Street 1:813 LINWOOD DR
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4853
Practice Address - Country:US
Practice Address - Phone:870-236-2364
Practice Address - Fax:870-236-2634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR4256207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR52571Medicare ID - Type UnspecifiedINDIVIDUAL
ARE93912Medicare UPIN
AR5B162Medicare ID - Type UnspecifiedGROUP