Provider Demographics
NPI:1073674024
Name:MORLEY, SUSAN LD (DO)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LD
Last Name:MORLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:DENT
Other - Last Name:MORLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:818 W MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MI
Mailing Address - Zip Code:48611-9200
Mailing Address - Country:US
Mailing Address - Phone:989-662-9890
Mailing Address - Fax:989-662-9891
Practice Address - Street 1:818 W MIDLAND RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MI
Practice Address - Zip Code:48611-9200
Practice Address - Country:US
Practice Address - Phone:989-662-9890
Practice Address - Fax:989-662-9891
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003306152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU78668Medicare UPIN
MI3855160001Medicare NSC