Provider Demographics
NPI:1326174020
Name:MORGAN, LEATHA BARBER (MD)
Entity Type:Individual
Prefix:DR
First Name:LEATHA
Middle Name:BARBER
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 VIRGINIA LOOP RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-4703
Mailing Address - Country:US
Mailing Address - Phone:334-284-9772
Mailing Address - Fax:334-284-9828
Practice Address - Street 1:4825 VIRGINIA LOOP RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-4703
Practice Address - Country:US
Practice Address - Phone:334-284-9772
Practice Address - Fax:334-284-9828
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14020208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000083670Medicaid
AL000083670Medicaid