Healthcare Provider Details

I. General information

NPI: 1497720478
Provider Name (Legal Business Name): GARY KEITH MORTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1912 AL HIGHWAY 157
CULLMAN AL
35058-0609
US

IV. Provider business mailing address

2151 OLD ROCKY RIDGE RD STE 106
BIRMINGHAM AL
35216-7251
US

V. Phone/Fax

Practice location:
  • Phone: 256-737-2585
  • Fax:
Mailing address:
  • Phone: 205-989-1080
  • Fax: 205-989-1087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD.18290
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD.18290
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: