Provider Demographics
NPI:1609105634
Name:MORGAN, ALONZO KEVIN SR (MA)
Entity Type:Individual
Prefix:MR
First Name:ALONZO
Middle Name:KEVIN
Last Name:MORGAN
Suffix:SR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31058 WHEATON
Mailing Address - Street 2:201
Mailing Address - City:NEW HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:48165-9469
Mailing Address - Country:US
Mailing Address - Phone:248-796-2639
Mailing Address - Fax:313-557-0678
Practice Address - Street 1:31058 WHEATON
Practice Address - Street 2:201
Practice Address - City:NEW HUDSON
Practice Address - State:MI
Practice Address - Zip Code:48165-9469
Practice Address - Country:US
Practice Address - Phone:248-796-2639
Practice Address - Fax:313-575-0678
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-22
Last Update Date:2011-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor