Healthcare Provider Details

I. General information

NPI: 1629141395
Provider Name (Legal Business Name): JAMES KEITH MORGAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 10/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W 3RD ST
GEORGETOWN TX
78626-5030
US

IV. Provider business mailing address

100 W 3RD ST
GEORGETOWN TX
78626-5030
US

V. Phone/Fax

Practice location:
  • Phone: 512-943-3600
  • Fax: 512-943-1499
Mailing address:
  • Phone: 512-943-3600
  • Fax: 512-943-1499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberH0655
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: