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General NPI Number Information
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NPI Number | 1508979915
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Entity Type | Individual
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Provider Name | THOMAS JACKSON MORGAN JR. D. C.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 4807 SHORE DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-2714
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Country | US
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Telephone | 757-498-8455
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Fax | 757-463-5764
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Provider Business Mailing Address
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Address Line | 4837 SHORE DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-2714
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Country | US
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Telephone | 757-222-9462
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Fax |
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 0104001216
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License Number State | VA
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