Provider Demographics
NPI:1588648356
Name:MORTON, JOHN R (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:MORTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:111 BREWSTER ST
Mailing Address - Street 2:DEPARTMENT OF OB/GYN
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4400
Mailing Address - Country:US
Mailing Address - Phone:401-729-3600
Mailing Address - Fax:401-729-2580
Practice Address - Street 1:174 ARMISTICE BLVD
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-3210
Practice Address - Country:US
Practice Address - Phone:401-729-3600
Practice Address - Fax:401-729-2580
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2010-05-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIMD11288207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007056669OtherMEDICARE PTAN
RI9026805Medicaid
RIH95441Medicare UPIN