Provider Demographics
NPI:1972583615
Name:MORRIS, GARY L (DC)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:L
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 GRAVOIS RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-4721
Mailing Address - Country:US
Mailing Address - Phone:314-351-2500
Mailing Address - Fax:314-351-2877
Practice Address - Street 1:8000 GRAVOIS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-4721
Practice Address - Country:US
Practice Address - Phone:314-351-2500
Practice Address - Fax:314-351-2877
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005366111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO177314OtherBLUECROSS/BLUESHIELD OF M
MO217947OtherANTHEM BLUECROSS/BLUE SHIELD
MO4367198OtherAETNA
MO4400453OtherUNITEDHEALTHCARE
MO0625293001OtherCIGNA HEALTHCARE
MO177314OtherBLUECROSS/BLUESHIELD OF M
MO313825424Medicare PIN