Provider Demographics
NPI:1003848821
Name:MORGAN, MARLA B (MD)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:B
Last Name:MORGAN
Suffix:
Gender:F
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:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:
Practice Address - Street 1:619 19TH STREET SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-934-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL228352084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL25999OtherHEALTHSPRING OF ALABAMA
AL000016300Medicaid
AL110036323OtherRAILROAD MEDICARE
AL000016300OtherBLUE CROSS
AL051516264OtherBLUE CROSS
AL051516266OtherBLUE CROSS
ALC73786OtherVIVA
ALP00034065OtherRAILROAD MEDICARE
AL051553724Medicare ID - Type Unspecified
AL000016300Medicaid