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General NPI Number Information
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NPI Number | 1790147841
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Entity Type | Individual
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Provider Name | MORGAN DRAKE MD
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Gender | Female
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Dates
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Enumeration Date | 03/27/2016
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 153 E MONTE PAINTER DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4002
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Country | US
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Telephone | 870-370-1374
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3106
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City | BENTONVILLE
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State | AR
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Zip | 72712-7711
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Country | US
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Telephone | 479-601-2314
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2023005040
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | E-13073
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License Number State | AR
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