Provider Demographics
NPI:1811071830
Name:MORGANTON FAMILY MEDICINE PLLC
Entity type:Organization
Organization Name:MORGANTON FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:ANDREWS
Authorized Official - Last Name:DEEKENS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:828-437-0666
Mailing Address - Street 1:115 FOOTHILLS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655
Mailing Address - Country:US
Mailing Address - Phone:828-437-0666
Mailing Address - Fax:828-438-1773
Practice Address - Street 1:115 FOOTHILLS DRIVE
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655
Practice Address - Country:US
Practice Address - Phone:828-437-0666
Practice Address - Fax:828-438-1773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty