Healthcare Provider Details

I. General information

NPI: 1205879301
Provider Name (Legal Business Name): SIDNEY JOSEPH MORGAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 ROCKY FORD RD
SYLVANIA GA
30467-2027
US

IV. Provider business mailing address

460 MALL BVLD SUITE B
SAVANNAH GA
31406
US

V. Phone/Fax

Practice location:
  • Phone: 912-564-7133
  • Fax: 912-564-2619
Mailing address:
  • Phone: 912-644-5300
  • Fax: 912-644-5260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21262
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: