Provider Demographics
NPI:1366141798
Name:MORRIS, DUSTIN D
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:D
Last Name:MORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 JOHN WESLEY DOBBS AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1690
Mailing Address - Country:US
Mailing Address - Phone:954-361-5256
Mailing Address - Fax:954-361-4243
Practice Address - Street 1:691 JOHN WESLEY DOBBS AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1690
Practice Address - Country:US
Practice Address - Phone:954-361-5256
Practice Address - Fax:954-361-4243
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-24
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332B00000X
332BC3200X, 332BN1400X, 332BX2000X, 343900000X, 332BD1200X
GA1366141798332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)