Provider Demographics
NPI:1285672899
Name:MORTON, GEORGE THOMAS III (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:THOMAS
Last Name:MORTON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:RIFLE
Mailing Address - State:CO
Mailing Address - Zip Code:81650-2332
Mailing Address - Country:US
Mailing Address - Phone:970-625-5521
Mailing Address - Fax:970-625-9339
Practice Address - Street 1:220 EAST AVE
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650-2332
Practice Address - Country:US
Practice Address - Phone:970-625-5521
Practice Address - Fax:970-625-9339
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16787207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01167873Medicaid
COJ7218Medicare ID - Type Unspecified
CO01167873Medicaid