Healthcare Provider Details

I. General information

NPI: 1518660703
Provider Name (Legal Business Name): TIMOTHY J MORLEY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MARKET ST # 1
BOARDMAN OH
44512-6725
US

IV. Provider business mailing address

130 RIVER RD APT Q105
MUSCLE SHOALS AL
35661-1359
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-8770
  • Fax:
Mailing address:
  • Phone: 208-497-9207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number58033507
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: