Healthcare Provider Details

I. General information

NPI: 1861105330
Provider Name (Legal Business Name): MRS. IRIS RENEE MORGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 12/29/2022
Certification Date: 12/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5511 HIGHWAY 280 STE 104
BIRMINGHAM AL
35242-1506
US

IV. Provider business mailing address

380 LAKE KATHRYN DR
STERRETT AL
35147-8068
US

V. Phone/Fax

Practice location:
  • Phone: 205-438-6406
  • Fax: 888-502-4077
Mailing address:
  • Phone: 205-913-7622
  • Fax: 888-502-4077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: