Individual
DR. LARRY DONAVON MORRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
785 S HIGHWAY 59, MAHNOMEN, MN 56557-5007
(218) 936-2020
(218) 935-5541
Mailing address
785 SO HIGHWAY 59, P O BOX 339, MAHNOMEN, MN 56557-5007
(218) 936-2020
(218) 935-5541
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1739
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051127011
METROPOLITAN HEALTH PLAN
MN
01
—
0559830003
DMERC
MN
01
—
0M036MO
NATIONAL TRIBAL CLAIMS CE
MN
01
—
2229857
MEDICA
MN
01
—
410036752
PALMETTO GBA
MN
01
—
411895571101
UNICARE
MN
01
—
483361046247
PREFERRED ONE
MN
01
—
553P1MO
BCBS
MN
05
—
906223800
—
MN
Enumeration date
07/08/2005
Last updated
08/22/2008
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