Healthcare Provider Details

I. General information

NPI: 1376934372
Provider Name (Legal Business Name): MARGARET MORRISON KSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGARET MORRISON SURGICAL ASSISTANT

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 06/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 KENDELL THOMAS RD
BARLOW KY
42024-9732
US

IV. Provider business mailing address

340 KENDELL THOMAS RD
BARLOW KY
42024-9732
US

V. Phone/Fax

Practice location:
  • Phone: 270-559-4543
  • Fax: 270-224-2789
Mailing address:
  • Phone: 270-559-4543
  • Fax: 270-224-2789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License NumberSA258
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: