Provider Demographics
NPI:1336170224
Name:MORLEY, BRIAN P (DO)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:P
Last Name:MORLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:PROSPECT PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19076-1112
Mailing Address - Country:US
Mailing Address - Phone:215-359-5330
Mailing Address - Fax:
Practice Address - Street 1:1526 EVANS AVE
Practice Address - Street 2:
Practice Address - City:PROSPECT PARK
Practice Address - State:PA
Practice Address - Zip Code:19076-1112
Practice Address - Country:US
Practice Address - Phone:215-359-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO113205207Q00000X
PAOS015020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO244981114Medicaid
H22343Medicare UPIN
MO244981114Medicaid