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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639158900 NPPES
South Carolina MEDICAID ZG0327

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