Timothy Morris
Individual provider Active NPI Driver · Monument, NM
NPI 1568035582 · NPPES record last updated Jul 19, 2021
Key facts
- NPI
- 1568035582
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 509241813 (NM)
- Practice address
- 10395 Redfearn Rd
Monument, NM 88265-8826 - Phone
- (646) 974-0035
- NPI assigned
- Jul 19, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 509241813 | NM | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 509241813 | NM | Yes |
Addresses
Primary practice location
10395 Redfearn Rd
Monument, NM 88265-8826
Mailing address
HC 69 Box 66
Monument, NM 88265-9704
Phone (646) 974-0035
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.