Healthcare Provider Details

I. General information

NPI: 1669441291
Provider Name (Legal Business Name): TODD DAVID MORGAN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 05/24/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 SUTTON ROAD VISION CENTER
OWENS CROSS ROADS AL
35763
US

IV. Provider business mailing address

330 SUTTON ROAD VISION CENTER
OWENS CROSS ROADS AL
35763
US

V. Phone/Fax

Practice location:
  • Phone: 256-534-4191
  • Fax: 256-534-4681
Mailing address:
  • Phone: 256-457-5036
  • Fax: 256-534-4681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS877 TA438
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: