Healthcare Provider Details

I. General information

NPI: 1427372754
Provider Name (Legal Business Name): KEVIN CHARLES MORGAN OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2010
Last Update Date: 03/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 E FLAMINGO RD
LAS VEGAS NV
89119-5170
US

IV. Provider business mailing address

4970 HIGHWAY 371
HEFLIN LA
71039-5318
US

V. Phone/Fax

Practice location:
  • Phone: 702-784-4300
  • Fax: 702-784-4331
Mailing address:
  • Phone: 318-218-0850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberZ12121
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT790
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: