Provider Demographics
NPI:1245783356
Name:MORGAN, KEITH LYNN (MD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:LYNN
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24-26 AVE DO SIDONIO PAIS
Mailing Address - Street 2:FU WAH COURT, 1-D
Mailing Address - City:MACAU
Mailing Address - State:SAR
Mailing Address - Zip Code:00000
Mailing Address - Country:MO
Mailing Address - Phone:8536-667-1492
Mailing Address - Fax:8532-856-3593
Practice Address - Street 1:24-26 AVE DO SIDONIO PAIS
Practice Address - Street 2:FU WAH COURT, 1-D
Practice Address - City:MACAU
Practice Address - State:SAR
Practice Address - Zip Code:00000
Practice Address - Country:MO
Practice Address - Phone:8536-667-1492
Practice Address - Fax:8532-856-3593
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.14774207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine