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General NPI Number Information
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NPI Number | 1073502167
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Entity Type | Organization
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Legal Business Name | GARY L MORGAN OD PC
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 18431 N 91ST AVE SUITE 1
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City | PEORIA
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State | AZ
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Zip | 85382-0817
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Country | US
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Telephone | 623-933-6586
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Fax | 623-933-9320
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Provider Business Mailing Address
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Address Line | 18431 N 91ST AVE SUITE 1
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City | PEORIA
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State | AZ
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Zip | 85382-0817
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Country | US
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Telephone | 623-933-6586
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Fax | 623-933-9320
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MS. SHARON GLASS
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Credential |
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Telephone | 623-933-6586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | AZ845
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License Number State | AZ
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