Provider Demographics
NPI:1134132731
Name:MORGAN, KENNETH P (DPM)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:P
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 1:950 E HARVARD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-7007
Mailing Address - Country:US
Mailing Address - Phone:303-777-8767
Mailing Address - Fax:303-996-1336
Practice Address - Street 1:950 E HARVARD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-7007
Practice Address - Country:US
Practice Address - Phone:303-777-8767
Practice Address - Fax:303-996-1336
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO605213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82075719Medicaid
CO459778Medicare PIN
CO82075719Medicaid