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General NPI Number Information
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NPI Number | 1205048998
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Entity Type | Organization
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Legal Business Name | CHARLES G. MORGAN, JR. MD
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 11/21/2007
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Provider Practice Location Address
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Address Line | 1506 ROYAL AVE
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City | MONROE
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State | LA
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Zip | 71201-5610
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Country | US
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Telephone | 318-361-0016
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Fax |
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Provider Business Mailing Address
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Address Line | 1506 ROYAL AVE
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City | MONROE
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State | LA
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Zip | 71201-5610
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Country | US
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Telephone | 318-361-0016
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. CHARLES G MORGAN
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Credential | MD
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Telephone | 318-361-0016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 07580R
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License Number State | LA
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