Provider Demographics
NPI:1346387305
Name:MORRIS, LOWELL GARDNER (PA-C)
Entity type:Individual
Prefix:MR
First Name:LOWELL
Middle Name:GARDNER
Last Name:MORRIS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 S LAWRENCE RD # 655
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84528-5517
Mailing Address - Country:US
Mailing Address - Phone:435-687-5162
Mailing Address - Fax:435-687-5163
Practice Address - Street 1:625 NORTH, 400 EAST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:UT
Practice Address - Zip Code:84528
Practice Address - Country:US
Practice Address - Phone:435-687-5162
Practice Address - Fax:435-687-5163
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2025-08-14
Deactivation Date:2025-07-02
Deactivation Code:
Reactivation Date:2025-08-11
Provider Licenses
StateLicense IDTaxonomies
FLPA91909559363AM0700X
UT5368731-8002363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT463985Medicare Oscar/Certification