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General NPI Number Information
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NPI Number | 1922270792
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Entity Type | Organization
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Legal Business Name | MORGAN DERMPATH LABS INC
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 01/14/2015
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Provider Practice Location Address
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Address Line | 801 MAPLEWOOD DRIVE SUITE 5
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City | JUPITER
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State | FL
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Zip | 33458-8800
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Country | US
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Telephone | 561-575-1788
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Fax | 561-575-1789
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Provider Business Mailing Address
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Address Line | 801 MAPLEWOOD DRIVE SUITE 5
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City | JUPITER
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State | FL
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Zip | 33458-8800
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Country | US
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Telephone | 561-575-1788
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Fax | 561-575-1789
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JEFFERSON DAVIS MORGAN
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Credential | M.D.
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Telephone | 561-575-1788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 800022993
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License Number State | FL
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