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General NPI Number Information
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NPI Number | 1669413886
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Entity Type | Individual
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Provider Name | WAYNE L MORTON MD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 101 GIESLER DRIVE
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City | OSCEOLA
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State | MO
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Zip | 64776-6297
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Country | US
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Telephone | 417-646-8123
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Fax | 417-646-8911
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Provider Business Mailing Address
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Address Line | PO BOX 570
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City | OSCEOLA
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State | MO
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Zip | 64776-0570
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Country | US
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Telephone | 417-646-8123
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Fax | 417-646-8911
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R6098
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | R6098
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License Number State | MO
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