Healthcare Provider Details

I. General information

NPI: 1174696660
Provider Name (Legal Business Name): CHARLES P MORGAN PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 KATLIAN ST STE E
SITKA AK
99835-7359
US

IV. Provider business mailing address

700 KATLIAN ST STE E
SITKA AK
99835-7359
US

V. Phone/Fax

Practice location:
  • Phone: 907-747-5861
  • Fax: 907-747-5415
Mailing address:
  • Phone: 907-747-5861
  • Fax: 907-747-5415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number483
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: