Provider Demographics
NPI:1003809781
Name:MORGAN, STEVEN WESLEY (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:WESLEY
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3183 W STATE ST
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-1712
Mailing Address - Country:US
Mailing Address - Phone:423-764-0987
Mailing Address - Fax:423-652-2512
Practice Address - Street 1:3183 W STATE ST
Practice Address - Street 2:SUITE 1201
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-1712
Practice Address - Country:US
Practice Address - Phone:423-764-0987
Practice Address - Fax:423-652-2512
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN130852084N0400X
VA01010356832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3000869Medicaid
VA010336015Medicaid
VA007101147Medicaid
KY6492469900Medicaid
TN68843Medicaid
VA007101147Medicaid
KY6492469900Medicaid
TN103I132844Medicare PIN
TN3000869Medicare PIN
TNA96651Medicare UPIN
TN68843Medicaid
VAVVG105B88Medicare PIN
GA130014556Medicare PIN
VAC04525Medicare PIN
TNP00401572Medicare PIN
TN3384233Medicare PIN