Healthcare Provider Details

I. General information

NPI: 1770745630
Provider Name (Legal Business Name): ANDREA MORGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18199 HIGHWAY 80
HICKORY MS
39332-3452
US

IV. Provider business mailing address

PO BOX 220
HICKORY MS
39332-0220
US

V. Phone/Fax

Practice location:
  • Phone: 601-646-5445
  • Fax: 601-646-5446
Mailing address:
  • Phone: 601-646-5445
  • Fax: 601-646-5446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21523
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: