Healthcare Provider Details
I. General information
NPI: 1386026466
Provider Name (Legal Business Name): ELIZABETH HALE MORGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/24/2015
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1520 E BATES
SPRINGFIELD MO
65804-8425
US
IV. Provider business mailing address
1929 S SCENIC AVE
SPRINGFIELD MO
65807-2153
US
V. Phone/Fax
- Phone: 417-222-3395
- Fax:
- Phone: 479-799-5283
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | E-11248 |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 22189 |
| License Number State | NV |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 2024041690 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: