Healthcare Provider Details

I. General information

NPI: 1811400641
Provider Name (Legal Business Name): JANICE LA TARCIA MORTON-HUNTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2017
Last Update Date: 11/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N LAFAYETTE ST STE A
MOBILE AL
36604-2258
US

IV. Provider business mailing address

757 AIRMONT DR
MOBILE AL
36609-6547
US

V. Phone/Fax

Practice location:
  • Phone: 251-438-4222
  • Fax:
Mailing address:
  • Phone: 251-344-2818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10411
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: