MEDICARE: MARGO ALINE WALTON MORGAN

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
1	363LA2200X	Adult Health Nurse Practitioner	RN307350	GA
2	363L00000X	Nurse Practitioner	RN307350	GA

General Provider Information

NPI Number	:	1528829421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGO ALINE WALTON MORGAN

Provider Business Mailing Address
First Line	:	1936 DISCOVERY PARK LN
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-7700
Country	:	US
Telephone Number	:	513-504-0666
Fax Number	:

Provider Business Practice Location Address
First Line	:	1365 CLIFTON RD NE BLDG A
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1013
Country	:	US
Telephone Number	:	404-778-7777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2024
Last Update Date	:	01/21/2026

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