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Individual

DR. KENNETH J MORRISSEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1150 RESERVOIR AVENUE, SUITE 200, CRANSTON, RI 02920-6064
(401) 944-8700
(401) 944-8767
Mailing address
1150 RESERVOIR AVENUE, SUITE 200, CRANSTON, RI 02920-6064
(401) 944-8700
(401) 944-8767

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD06506
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200054
BLUE CHIP
RI
01
2080
BC
RI
05
9002080
RI
Enumeration date
11/20/2006
Last updated
06/22/2017
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