Healthcare Provider Details

I. General information

NPI: 1134106305
Provider Name (Legal Business Name): BRUCE K MORGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4959 HIGHWAY 83 NORTH
SEELEY LAKE MT
59868
US

IV. Provider business mailing address

PO BOX 579
SEELEY LAKE MT
59868-0579
US

V. Phone/Fax

Practice location:
  • Phone: 406-677-0696
  • Fax:
Mailing address:
  • Phone: 406-370-1224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number10672
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: