Provider Demographics
NPI:1457391369
Name:MORGAN, BRUCE ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:ARTHUR
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BRUCE
Other - Middle Name:A
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:833 SAINT VINCENTS DR
Mailing Address - Street 2:STE 402
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1606
Mailing Address - Country:US
Mailing Address - Phone:205-933-9236
Mailing Address - Fax:205-933-9213
Practice Address - Street 1:833 SAINT VINCENTS DR
Practice Address - Street 2:STE 402
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1606
Practice Address - Country:US
Practice Address - Phone:205-933-9236
Practice Address - Fax:205-933-9213
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26242207Q00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102021Medicaid
AL051530064OtherBLUE CROSS BLUE SHIELD
AL051530064Medicare ID - Type Unspecified
AL051530064OtherBLUE CROSS BLUE SHIELD