Provider Demographics
NPI:1669009262
Name:MORGAN, CARLY ELIZABETH (DO, ATC)
Entity type:Individual
Prefix:DR
First Name:CARLY
Middle Name:ELIZABETH
Last Name:MORGAN
Suffix:
Gender:F
Credentials:DO, ATC
Other - Prefix:DR
Other - First Name:CARLY
Other - Middle Name:ELIZABETH
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO, ATC
Mailing Address - Street 1:8040 PRINCETON GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5802
Mailing Address - Country:US
Mailing Address - Phone:513-246-7000
Mailing Address - Fax:
Practice Address - Street 1:8040 PRINCETON GLENDALE RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5802
Practice Address - Country:US
Practice Address - Phone:513-246-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.016385207QS0010X, 207Q00000X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer