Provider Demographics
NPI:1255372983
Name:CHARLES E. MORTON M.D.PC
Entity type:Organization
Organization Name:CHARLES E. MORTON M.D.PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:615-832-8186
Mailing Address - Street 1:2021 CHURCH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2021
Mailing Address - Country:US
Mailing Address - Phone:615-284-2400
Mailing Address - Fax:
Practice Address - Street 1:2021 CHURCH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2021
Practice Address - Country:US
Practice Address - Phone:615-284-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8766208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3373536Medicare PIN