Provider Demographics
NPI:1659658615
Name:MORGAN FAMILY PRACTICE, LLC
Entity Type:Organization
Organization Name:MORGAN FAMILY PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:W
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-586-1212
Mailing Address - Street 1:141 GOLFVIEW DR NE
Mailing Address - Street 2:
Mailing Address - City:ARAB
Mailing Address - State:AL
Mailing Address - Zip Code:35016-5473
Mailing Address - Country:US
Mailing Address - Phone:256-586-1212
Mailing Address - Fax:256-931-2270
Practice Address - Street 1:141 GOLFVIEW DR NE
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016-5473
Practice Address - Country:US
Practice Address - Phone:256-586-1212
Practice Address - Fax:256-931-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD18286207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL27-00338934OtherTAX ID
ALF83302Medicare UPIN