Individual
MARK JOHN MORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 MEMORIAL DR STE A, DANVILLE, VA 24541-1680
(434) 799-3232
Mailing address
2010 BREMO RD STE 128A, RICHMOND, VA 23226-2444
(877) 969-0392
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101046318
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047334
ANTHEM
VA
01
—
180024520
MEDICARE RR
—
01
—
3053992
TRICARE
—
05
—
6302190
—
VA
Enumeration date
07/13/2005
Last updated
02/07/2022
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