| Morrison Medical Enterprises | |
|
1307 Porter Wagoner Blvd West Plains MO 65775-1828 | |
| (417) 255-8645 | |
| (417) 255-8649 |
| Full Name | Morrison Medical Enterprises |
|---|---|
| Speciality | Family Medicine |
| Location | 1307 Porter Wagoner Blvd, West Plains, Missouri |
| Authorized Official Name and Position | Derek Jon Morrison (OWNER) |
| Authorized Official Contact | 4172558645 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Morrison Medical Enterprises 1307 Porter Wagoner Blvd West Plains MO 65775-1828 Ph: (417) 255-8645 | Morrison Medical Enterprises 1307 Porter Wagoner Blvd West Plains MO 65775-1828 Ph: (417) 255-8645 |
| NPI Number | 1881944163 |
|---|---|
| Provider Enumeration Date | 09/14/2012 |
| Last Update Date | 03/31/2015 |
| Medicare PECOS PAC ID | 7315196888 |
|---|---|
| Medicare Enrollment ID | O20120927000699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881944163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2010028285 (Missouri) | Primary |
| Provider Name | Derek J Morrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477782621 PECOS PAC ID: 8123143955 Enrollment ID: I20100916000318 |
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