Morris, Walter Jack
Morris, Walter Jack is an individual health care provider with primary practice located at 1459 Laney Walker Blvd Ad1501, Augusta GA 30912-0002. He recently has 2 registered licenses in different health care specialties including Dental Providers / Prosthodontics, Dental Providers / Dentist. Dental Providers / Prosthodontics is his primary health care specialty. Morris, Walter Jack can be contacted via phone (706) 721-0502.Contact Information
Primary practice address
1459 Laney Walker Blvd Ad1501
Augusta GA 30912-0002
Phone: (706) 721-0502
Fax: (706) 721-6778
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Prosthodontics | 1223P0700X | LNO3956 | Alabama |
| Dental Providers / Dentist | 122300000X | LNO3956 | Alabama |
Profile Details
| NPI number | 1639158900 |
|---|---|
| LBN Legal business name | Morris, Walter Jack |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 13th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639158900 | NPPES |
| South Carolina | MEDICAID | ZG0327 |
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