Provider Demographics
NPI:1023632478
Name:MORGAN, SYDNEE S (OD)
Entity type:Individual
Prefix:
First Name:SYDNEE
Middle Name:S
Last Name:MORGAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SYDNEE
Other - Middle Name:V
Other - Last Name:SNAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:107 EAST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857
Mailing Address - Country:US
Mailing Address - Phone:423-272-2020
Mailing Address - Fax:423-272-5886
Practice Address - Street 1:107 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37857
Practice Address - Country:US
Practice Address - Phone:423-272-2020
Practice Address - Fax:423-272-5886
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002892152W00000X
TNOD3620152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ059183Medicaid