Provider Demographics
NPI:1073593307
Name:MORGAN, ANTHONY HUGH (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:HUGH
Last Name:MORGAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-1128
Mailing Address - Country:US
Mailing Address - Phone:860-537-5520
Mailing Address - Fax:860-537-5590
Practice Address - Street 1:7 PARK AVE
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-1128
Practice Address - Country:US
Practice Address - Phone:860-537-5520
Practice Address - Fax:860-537-5590
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000718213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004204616Medicaid
CT004204616Medicaid
CT1318710001Medicare NSC
CTU79058Medicare UPIN