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NPI Code Detail

MEDICARE: KEVIN CHARLES MORGAN OTR

MEDICARE: KEVIN CHARLES MORGAN OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistZ12121LA
2225X00000XOccupational TherapistOT790HI

General Provider Information

NPI Number : 1427372754
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN CHARLES MORGAN OTR
Provider Business Mailing Address
First Line : 4970 HIGHWAY 371
Second Line :
City : HEFLIN
State : LA
Zip : 71039-5318
Country : US
Telephone Number : 318-218-0850
Fax Number :
Provider Business Practice Location Address
First Line : 2250 E FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5170
Country : US
Telephone Number : 702-784-4300
Fax Number : 702-784-4331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2010
Last Update Date : 03/15/2010

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