Healthcare Provider Details

I. General information

NPI: 1184789406
Provider Name (Legal Business Name): JOSEPH E MORTON D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 N ELM ST
HENDERSON KY
42420-2709
US

IV. Provider business mailing address

822 N ELM ST P.O. BOX 461
HENDERSON KY
42420-2709
US

V. Phone/Fax

Practice location:
  • Phone: 270-826-8899
  • Fax: 270-826-8913
Mailing address:
  • Phone: 270-826-8899
  • Fax: 270-826-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberKY5591
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: