Provider Demographics
NPI:1053380659
Name:MORRISON, SUSAN JANELL (DO)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:JANELL
Last Name:MORRISON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 HAHNS PEAK DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8852
Mailing Address - Country:US
Mailing Address - Phone:303-403-6350
Mailing Address - Fax:303-403-6372
Practice Address - Street 1:5200 HAHNS PEAK DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-8852
Practice Address - Country:US
Practice Address - Phone:970-962-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2019-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35989207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05638572Medicaid
1053380659OtherNPI
COCO306364Medicare PIN
C535268Medicare PIN
CO061844Medicare ID - Type Unspecified
COH29710Medicare UPIN