Healthcare Provider Details

I. General information

NPI: 1447313291
Provider Name (Legal Business Name): MORTON HOSPITALISTS AND INTERNAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 PLAZA WAY NW SUITE D
MARIETTA GA
30060-1141
US

IV. Provider business mailing address

PO BOX 2224
MARIETTA GA
30061-2224
US

V. Phone/Fax

Practice location:
  • Phone: 770-425-4350
  • Fax: 770-425-4365
Mailing address:
  • Phone: 770-425-4350
  • Fax: 770-425-4365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number046185
License Number StateGA

VIII. Authorized Official

Name: DR. LASONGIA MORTON
Title or Position: OWNER
Credential: M.D.
Phone: 404-396-6033