Basic Information
Provider Information
NPI: 1194068320
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRIS
FirstName: ANDREW
MiddleName: DAVID
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 1ST ST SW
Address2:  
City: ROCHESTER
State: MN
PostalCode: 559050001
CountryCode: US
TelephoneNumber: 6087850940
FaxNumber:  
Practice Location
Address1: 700 WEST AVE S
Address2:  
City: LA CROSSE
State: WI
PostalCode: 546014783
CountryCode: US
TelephoneNumber: 6087850940
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/06/2013
LastUpdateDate: 08/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X20855WIY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


Home