Provider Demographics
NPI:1174581714
Name:MORRIS, RICHARD C (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:105 RICHESON DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2911
Mailing Address - Country:US
Mailing Address - Phone:434-385-7776
Mailing Address - Fax:434-385-5846
Practice Address - Street 1:105 RICHESON DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2911
Practice Address - Country:US
Practice Address - Phone:434-385-7776
Practice Address - Fax:434-385-5846
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101030953208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006784691Medicaid
VA006784691Medicaid