Provider Demographics
NPI:1871520577
Name:MORRIS, JAMES MARK (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MARK
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9477
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75711-9477
Mailing Address - Country:US
Mailing Address - Phone:903-594-2450
Mailing Address - Fax:903-509-0493
Practice Address - Street 1:1801 N DICKINSON DR
Practice Address - Street 2:
Practice Address - City:RUSK
Practice Address - State:TX
Practice Address - Zip Code:75785-1264
Practice Address - Country:US
Practice Address - Phone:903-683-3600
Practice Address - Fax:903-683-3692
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH1397207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140147304OtherAMERIGROUP
TX140147304Medicaid
TX080140249OtherRAILROAD MEDICARE
TX84Z446OtherBLUE CROSS
TX080140249OtherRAILROAD MEDICARE
TX84Z446OtherBLUE CROSS
TX080140249Medicare PIN