Provider Demographics
NPI:1992027262
Name:MORTON, MICHAEL ANDERSON (DPH)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANDERSON
Last Name:MORTON
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-4437
Mailing Address - Country:US
Mailing Address - Phone:918-335-2146
Mailing Address - Fax:
Practice Address - Street 1:809 WINDING WAY
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-4437
Practice Address - Country:US
Practice Address - Phone:918-335-2146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9004183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist