Healthcare Provider Details

I. General information

NPI: 1265437263
Provider Name (Legal Business Name): CRAIG MICHAEL MORGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 08/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 13TH AVE
HUNTINGTON WV
25701-3811
US

IV. Provider business mailing address

1611 13TH AVE
HUNTINGTON WV
25701-3811
US

V. Phone/Fax

Practice location:
  • Phone: 304-522-6500
  • Fax: 304-522-1353
Mailing address:
  • Phone: 304-522-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number15269
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: