Provider Demographics
NPI:1568857191
Name:LOCK, MORGAN BRANTLEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:BRANTLEY
Last Name:LOCK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 BRANTLEY RD
Mailing Address - Street 2:
Mailing Address - City:TALLASSEE
Mailing Address - State:AL
Mailing Address - Zip Code:36078-4569
Mailing Address - Country:US
Mailing Address - Phone:334-224-6464
Mailing Address - Fax:
Practice Address - Street 1:10 GILMER AVE
Practice Address - Street 2:
Practice Address - City:TALLASSEE
Practice Address - State:AL
Practice Address - Zip Code:36078-1206
Practice Address - Country:US
Practice Address - Phone:334-283-3637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19453183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist