MEDICARE: DR. PETER M MORTON

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
1	103TC0700X	Clinical Psychologist	1776	AZ

General Provider Information

NPI Number	:	1902974900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER M MORTON

Provider Business Mailing Address
First Line	:	8433 N BLACK CANYON HWY
Second Line	:	SUITE 100
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4873
Country	:	US
Telephone Number	:	602-249-8707
Fax Number	:	602-788-0388

Provider Business Practice Location Address
First Line	:	8433 N BLACK CANYON HWY
Second Line	:	SUITE 100
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4873
Country	:	US
Telephone Number	:	602-249-8707
Fax Number	:	602-788-0388

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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