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Individual

ROBERT TIM MORRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1190 N STATE ST, LOWER LEVEL, JACKSON, MS 39202-2413
(601) 968-1377
(601) 292-4595
Mailing address
1190 N STATE ST, LOWER LEVEL, JACKSON, MS 39202-2413
(601) 968-1377
(601) 292-4595

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11755
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
168390705
US DEPT OF LABOR
MS
01
753068151004
TRICARE
MS
Enumeration date
03/16/2006
Last updated
02/09/2012
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