Provider Demographics
NPI:1558522615
Name:FORDHAM, MORGAN TAYLOR JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:TAYLOR
Last Name:FORDHAM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:315 N SAN SABA STE 1135
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3255
Mailing Address - Country:US
Mailing Address - Phone:210-704-3391
Mailing Address - Fax:210-704-4520
Practice Address - Street 1:333 N. SANTA ROSA, STE LL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207
Practice Address - Country:US
Practice Address - Phone:210-704-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-21
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP9851207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX337643601Medicaid