Provider Demographics
NPI:1720667082
Name:BRIDGFORTH, MORGAN J (MD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:J
Last Name:BRIDGFORTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:J
Other - Last Name:WOODWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS WAY # 512
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-5281
Mailing Address - Fax:
Practice Address - Street 1:1 CHILDRENS WAY # 512
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-5281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program