Provider Demographics
NPI:1922018217
Name:MORTON, ANTHONY JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOHN
Last Name:MORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1001 MONTCLAIRE DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-6127
Mailing Address - Country:US
Mailing Address - Phone:505-554-8581
Mailing Address - Fax:505-248-7733
Practice Address - Street 1:801 VASSAR DR NE
Practice Address - Street 2:ALBUQUERQUE INDIAN HEALTH CENTER
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2725
Practice Address - Country:US
Practice Address - Phone:505-248-4065
Practice Address - Fax:505-248-4093
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-113102084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM739715553Medicaid
NMHSZE53ZMHWMedicare PIN
NMHSZE53RFMMedicare PIN
NMHSZE53ZMJDMedicare PIN