Healthcare Provider Details
I. General information
NPI: 1508852161
Provider Name (Legal Business Name): ALETHIA E MORGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1120 MINNEQUA AVE
PUEBLO CO
81004-3734
US
IV. Provider business mailing address
1120 MINNEQUA AVE
PUEBLO CO
81004-3734
US
V. Phone/Fax
- Phone: 719-564-0660
- Fax: 719-564-0037
- Phone: 719-564-0660
- Fax: 719-564-0037
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 28571 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: