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General NPI Number Information
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NPI Number | 1740653146
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Entity Type | Individual
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Provider Name | ISSAC DRAKE MORTON DMD, MD
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Gender | Male
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Dates
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Enumeration Date | 11/06/2015
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 7777 HENNESSY BLVD MEDICAL PLAZA 1, SUITE 306
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City | BATON ROUGE
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State | LA
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Zip | 70808
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Country | US
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Telephone | 225-763-3939
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Fax | 225-763-3947
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Provider Business Mailing Address
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Address Line | 7777 HENNESSY BLVD STE 306
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City | BATON ROUGE
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State | LA
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Zip | 70808-4365
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Country | US
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Telephone | 225-763-3939
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Fax | 225-763-3947
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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 | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 36130
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 11335
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 345913
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 7712
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License Number State | LA
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