Luther Dwayne Morris, D. C.

Individual provider Active NPI Chiropractor · Santa Clara, NM

NPI 1871508648 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1871508648
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
NM 529 (NM)
Practice address
12087 Hwy 180 E.
Santa Clara, NM 88026
Phone
(505) 537-2976
Fax
(505) 537-2976
NPI assigned
Jul 30, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100701000690 NM Practitioner - Chiropractic 9638200892

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
NM 529NMMDChiropractor
529NMMDAcupuncturist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NM 529 NM Yes

Addresses

Primary practice location

12087 Hwy 180 E.
Santa Clara, NM 88026

Mailing address

12087 Hwy 180 & 152, Santa Clara, NM
P.O. Box 770
Bayard, NM 88043
Phone (505) 537-2976

Other identifiers

IdentifierTypeStateIssuer
201007042OtherNMPRESBYTERIAN
NMOOK789OtherNMBLUE CROSS BLUE SHIELD
648616OtherNMUNITED HEALTHCARE
350018216OtherNMRAIL ROAD
0000T8736MedicaidNM

Other providers in Santa Clara, NM

All providers in Santa Clara, NM · Chiropractor in New Mexico

Sources for this page

Verify at the official NPI Registry.