=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962423897
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MORGAN CARDIOVASCULAR, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2006
-----------------------------------------------------
Last Update Date | 04/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3035 CORDER DR
-----------------------------------------------------
City | CORINTH
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38834-6216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-665-0151
-----------------------------------------------------
Fax | 662-665-0158
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1345
-----------------------------------------------------
City | CORINTH
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38835-1345
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-665-0151
-----------------------------------------------------
Fax | 662-665-0158
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN/OWNER
-----------------------------------------------------
Name | KERRY MORGAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 662-665-0151
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 15760
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------