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NPI Code Detail

MEDICARE: MORGAN E GREEN PA

MEDICARE:   MORGAN E GREEN  PA
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 Assistant1978OK

General Provider Information

NPI Number : 1487951745
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN E GREEN PA
Provider Business Mailing Address
First Line : PO BOX 740020
Second Line :
City : ATLANTA
State : GA
Zip : 30374-0020
Country : US
Telephone Number : 405-453-8004
Fax Number : 405-561-4857
Provider Business Practice Location Address
First Line : 7521 SE 15TH ST
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73110-5425
Country : US
Telephone Number : 405-453-8004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2011
Last Update Date : 04/24/2026

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Directions to “ MORGAN E GREEN PA” Practice Location

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