Provider Demographics
NPI:1184841983
Name:MORTON, RICHARD PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PAUL
Last Name:MORTON
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 1:3345 KENSINGTON RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-1512
Mailing Address - Country:US
Mailing Address - Phone:404-299-2244
Mailing Address - Fax:404-299-9144
Practice Address - Street 1:3345 KENSINGTON RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-1512
Practice Address - Country:US
Practice Address - Phone:404-299-2244
Practice Address - Fax:404-299-9144
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007442111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHKJMedicare ID - Type Unspecified