Provider Demographics
NPI:1962680199
Name:LYNDON W MORGAN MD LLC
Entity Type:Organization
Organization Name:LYNDON W MORGAN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNDON
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-338-2571
Mailing Address - Street 1:158 NORTHPORT AVE
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6060
Mailing Address - Country:US
Mailing Address - Phone:207-338-2571
Mailing Address - Fax:207-338-3810
Practice Address - Street 1:158 NORTHPORT AVE
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6060
Practice Address - Country:US
Practice Address - Phone:207-338-2571
Practice Address - Fax:207-338-3810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME01297174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM0505Medicare UPIN
MEMM5147Medicare UPIN