Provider Demographics
NPI:1275655078
Name:MORGAN, THEODORE ANTHONY
Entity Type:Individual
Prefix:MR
First Name:THEODORE
Middle Name:ANTHONY
Last Name:MORGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4216 SIR ANDREW CIR
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-9653
Mailing Address - Country:US
Mailing Address - Phone:215-230-4869
Mailing Address - Fax:
Practice Address - Street 1:808 W STREET RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-3125
Practice Address - Country:US
Practice Address - Phone:215-674-9666
Practice Address - Fax:215-674-9930
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23-2518313OtherEIN