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Organization
MORRIS L MICKELSON MD PA
Active
Organization
MORRIS L MICKELSON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MORRIS MICKELSON M.D. (PRESIDENT/PHYSICIAN)
(936) 639-2244
Entity
Organization
Contact information
Practice address
1111 W FRANK AVE STE 100, LUFKIN, TX 75904-3390
(936) 639-2244
(936) 634-9334
Mailing address
1111 W FRANK AVE STE 100, LUFKIN, TX 75904-3390
(936) 639-2244
(936) 634-9334
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002ND
BCBS
TX
05
—
183860901
—
TX
Enumeration date
03/02/2007
Last updated
08/31/2017
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