Provider Demographics
NPI:1891359154
Name:DAVIS, MORGAN ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ELIZABETH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 WOODHILL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206-2302
Mailing Address - Country:US
Mailing Address - Phone:601-594-7868
Mailing Address - Fax:
Practice Address - Street 1:200 WEST ARBOR DRIVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8829
Practice Address - Country:US
Practice Address - Phone:619-543-7242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA181809207Y00000X
CAPTL2541390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology