Provider Demographics
NPI:1053761874
Name:MORRIS, DARRYL JEROME JR (OD)
Entity type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:JEROME
Last Name:MORRIS
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-2300
Mailing Address - Country:US
Mailing Address - Phone:864-226-6041
Mailing Address - Fax:864-226-1232
Practice Address - Street 1:2808 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-2300
Practice Address - Country:US
Practice Address - Phone:864-226-6041
Practice Address - Fax:864-226-1232
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1946152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist