Healthcare Provider Details

I. General information

NPI: 1174567689
Provider Name (Legal Business Name): MICHAEL T MORTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1960 OGDEN ST SUITE 400
DENVER CO
80218-1022
US

IV. Provider business mailing address

DEPT 557
DENVER CO
80291-0001
US

V. Phone/Fax

Practice location:
  • Phone: 303-318-1540
  • Fax: 303-318-2481
Mailing address:
  • Phone: 303-467-4162
  • Fax: 303-318-2488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number37288
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: