Healthcare Provider Details

I. General information

NPI: 1164522413
Provider Name (Legal Business Name): HEATHER MORGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER TALBERT HAWTHORNE MD

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 3RD ST. SUITE 425 GRAND ROUNDS, INC.
SAN FRANCISCO CA
94107
US

IV. Provider business mailing address

8084 CROSS CREEK DR
TALBOTT TN
37877-2900
US

V. Phone/Fax

Practice location:
  • Phone: 415-792-5305
  • Fax:
Mailing address:
  • Phone: 205-410-0502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL28000
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number29541
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberA121650
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: