Provider Demographics
NPI:1992847461
Name:MORGAN, ANGELA KRISTINA (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KRISTINA
Last Name:MORGAN
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 1:1404 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-5712
Mailing Address - Country:US
Mailing Address - Phone:405-330-8819
Mailing Address - Fax:405-340-0892
Practice Address - Street 1:1404 E 9TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-5712
Practice Address - Country:US
Practice Address - Phone:405-330-8819
Practice Address - Fax:405-340-0892
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24779207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200174830AMedicaid