Provider Demographics
NPI:1639512197
Name:MORTON, STEFFANY R (MD)
Entity Type:Individual
Prefix:
First Name:STEFFANY
Middle Name:R
Last Name:MORTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STEFFANY
Other - Middle Name:R
Other - Last Name:BAGNOLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1099 N MERIDIAN ST STE 800
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:330-426-0041
Practice Address - Street 1:1099 N MERIDIAN ST STE 800
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1046
Practice Address - Country:US
Practice Address - Phone:844-980-1862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1245272084P0800X
IN01090163A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry