Provider Demographics
NPI:1043781719
Name:MORGAN, DAVID (PA-C)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MORGAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 SEQUOIA RUBY CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-8656
Mailing Address - Country:US
Mailing Address - Phone:801-472-7764
Mailing Address - Fax:
Practice Address - Street 1:157 N RESERVATION DR
Practice Address - Street 2:
Practice Address - City:KANOSH
Practice Address - State:UT
Practice Address - Zip Code:84637-8463
Practice Address - Country:US
Practice Address - Phone:435-759-2610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8598346-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant