Provider Demographics
NPI:1376756080
Name:MORGAN-KITSON, FANTA VAUGHN (DPM)
Entity Type:Individual
Prefix:DR
First Name:FANTA
Middle Name:VAUGHN
Last Name:MORGAN-KITSON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:22 OLD RUDNICK LN
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4912
Mailing Address - Country:US
Mailing Address - Phone:302-674-9255
Mailing Address - Fax:302-674-9096
Practice Address - Street 1:22 OLD RUDNICK LN
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4912
Practice Address - Country:US
Practice Address - Phone:302-674-9255
Practice Address - Fax:302-674-9096
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005937213ES0103X
DEE1-0000188213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery