Provider Demographics
NPI:1417232075
Name:MORGAN, STEPHEN ALLEN
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ALLEN
Last Name:MORGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:ALLEN
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:620 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-3613
Mailing Address - Country:US
Mailing Address - Phone:931-424-5335
Mailing Address - Fax:931-424-6463
Practice Address - Street 1:620 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-3613
Practice Address - Country:US
Practice Address - Phone:931-424-5335
Practice Address - Fax:931-424-6463
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN76111835P0018X
MSE-061651835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist