Provider Demographics
NPI:1154327070
Name:MORGAN, GILBERT R (DC)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:R
Last Name:MORGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 BEAR HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64856-8204
Mailing Address - Country:US
Mailing Address - Phone:417-226-4736
Mailing Address - Fax:417-226-4405
Practice Address - Street 1:95 BEAR HOLLOW RD
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:MO
Practice Address - Zip Code:64856-8204
Practice Address - Country:US
Practice Address - Phone:417-226-4736
Practice Address - Fax:417-226-4405
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004328111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO43-1899310OtherFED TAX ID
MO000032246Medicare ID - Type UnspecifiedPROVIDER NUMBER
MOT 73759Medicare UPIN
350049377Medicare ID - Type UnspecifiedRAILROAD MEDICARE PROV.