Provider Demographics
NPI:1821043324
Name:MORGAN, WILLIAM ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:MORGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 SE FEDERAL HWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-4902
Mailing Address - Country:US
Mailing Address - Phone:772-221-8969
Mailing Address - Fax:772-221-8707
Practice Address - Street 1:3610 SE FEDERAL HWY
Practice Address - Street 2:SUITE 4
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-4902
Practice Address - Country:US
Practice Address - Phone:772-221-8969
Practice Address - Fax:772-221-8707
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6880111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381058500Medicaid
FL55246Medicare ID - Type Unspecified
FLU62610Medicare UPIN
FL381058500Medicaid