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NPI Code Detail

MEDICARE: DANIEL MORTON

MEDICARE:   DANIEL  MORTON
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
12471C3402XRadiography Radiologic TechnologistIL

General Provider Information

NPI Number : 1497943567
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL MORTON
Provider Business Mailing Address
First Line : 20421 N MILLER LAKE LN
Second Line :
City : TEXICO
State : IL
Zip : 62889-2812
Country : US
Telephone Number : 618-266-7141
Fax Number :
Provider Business Practice Location Address
First Line : 20421 N MILLER LAKE LN
Second Line :
City : TEXICO
State : IL
Zip : 62889-2812
Country : US
Telephone Number : 618-266-7141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2007
Last Update Date : 10/13/2007

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Directions to “ DANIEL MORTON ” Practice Location

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