Provider Demographics
NPI:1689005415
Name:MORGAN, DIMPLE
Entity Type:Individual
Prefix:
First Name:DIMPLE
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8912 NE 10TH ST
Mailing Address - Street 2:B
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-7106
Mailing Address - Country:US
Mailing Address - Phone:405-343-5291
Mailing Address - Fax:405-732-0683
Practice Address - Street 1:8912 NE 10TH ST
Practice Address - Street 2:B
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-7106
Practice Address - Country:US
Practice Address - Phone:405-343-5291
Practice Address - Fax:405-732-0683
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)