Provider Demographics
NPI:1821249970
Name:ROBERT L. MORGAN, M.D., P.C.
Entity Type:Organization
Organization Name:ROBERT L. MORGAN, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-444-7917
Mailing Address - Street 1:432 BOLAND ST
Mailing Address - Street 2:P O BOX C
Mailing Address - City:SPARTA
Mailing Address - State:GA
Mailing Address - Zip Code:31087-2041
Mailing Address - Country:US
Mailing Address - Phone:706-444-7917
Mailing Address - Fax:706-444-0420
Practice Address - Street 1:432 BOLAND ST
Practice Address - Street 2:P O BOX C
Practice Address - City:SPARTA
Practice Address - State:GA
Practice Address - Zip Code:31087-2041
Practice Address - Country:US
Practice Address - Phone:706-444-7917
Practice Address - Fax:706-444-0420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031639261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000443737AMedicaid
GA08BDQBRMedicare PIN
GA000443737AMedicaid