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NPI Code Detail

MEDICARE: NATHAN DEVEARL MORGAN PA-C

MEDICARE: NATHAN DEVEARL MORGAN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant10001466AIN

General Provider Information

NPI Number : 1215364674
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN DEVEARL MORGAN PA-C
Provider Business Mailing Address
First Line : 111 N NAPPANEE ST
Second Line :
City : ELKHART
State : IN
Zip : 46514-1957
Country : US
Telephone Number : 574-522-0265
Fax Number : 574-293-2855
Provider Business Practice Location Address
First Line : 6460 MEDICAL CENTER ST STE 350
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-2423
Country : US
Telephone Number : 702-255-6647
Fax Number : 702-933-1444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2013
Last Update Date : 05/07/2019

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