Provider Demographics
NPI:1790148823
Name:ARMSTRONG, MORGAN MIXON (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:MIXON
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:MORGAN
Other - Middle Name:MIRANDA
Other - Last Name:MIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:470 HULON LN
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-4841
Mailing Address - Country:US
Mailing Address - Phone:803-791-2000
Mailing Address - Fax:
Practice Address - Street 1:3314 PLATT SPRINGS RD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29170-2204
Practice Address - Country:US
Practice Address - Phone:803-791-3494
Practice Address - Fax:803-739-9854
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCTL2536363A00000X
SC2536363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant