Provider Demographics
NPI:1295734200
Name:MORTON, DAVID J (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:MORTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12855 N 40 DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8657
Mailing Address - Country:US
Mailing Address - Phone:314-880-6162
Mailing Address - Fax:314-997-3248
Practice Address - Street 1:10012 KENNERLY RD
Practice Address - Street 2:SUITE 300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2197
Practice Address - Country:US
Practice Address - Phone:314-842-0602
Practice Address - Fax:314-842-4372
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2012-06-26
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Provider Licenses
StateLicense IDTaxonomies
MOR4F78207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202280632Medicaid
MO202280616Medicaid
MO202280632Medicaid
MO202280616Medicaid
MOA10407Medicare UPIN