Provider Demographics
NPI:1700967809
Name:MORALES, NIXON E (MD)
Entity Type:Individual
Prefix:
First Name:NIXON
Middle Name:E
Last Name:MORALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 SW FRAZIER AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1963
Mailing Address - Country:US
Mailing Address - Phone:785-232-5005
Mailing Address - Fax:785-232-0160
Practice Address - Street 1:325 SW FRAZIER AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1963
Practice Address - Country:US
Practice Address - Phone:785-232-5005
Practice Address - Fax:785-232-0160
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS08-002932084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS292A00009OtherMEDICARE PTAN
KS200620420AMedicaid
KS292C00005OtherMEDICARE PTAN