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General NPI Number Information
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NPI Number | 1417189465
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Entity Type | Individual
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Provider Name | CLAY ERIC MORGAN PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/10/2009
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Last Update Date | 07/31/2020
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Provider Practice Location Address
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Address Line | 1500 LINE AVENUE STE 100
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City | SHREVEPORT
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State | LA
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Zip | 71101-4639
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Country | US
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Telephone | 318-635-3052
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Fax | 318-635-3072
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Provider Business Mailing Address
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Address Line | 1534 ELIZABETH AVE STE 301
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City | SHREVEPORT
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State | LA
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Zip | 71101-4531
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Country | US
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Telephone | 318-629-5001
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Fax | 318-629-5020
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 200336
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License Number State | LA
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