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NPI Code Detail

MEDICARE: MARY J. MORGAN DPH

MEDICARE: MARY J. MORGAN DPH
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
1183500000XPharmacist12166OK

General Provider Information

NPI Number : 1558477091
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY J. MORGAN DPH
Provider Business Mailing Address
First Line : 1801 E 4TH ST
Second Line :
City : OKMULGEE
State : OK
Zip : 74447-3942
Country : US
Telephone Number : 918-756-3334
Fax Number : 918-756-4949
Provider Business Practice Location Address
First Line : 309 N 14TH ST
Second Line :
City : OKEMAH
State : OK
Zip : 74859-2028
Country : US
Telephone Number : 918-623-1424
Fax Number : 918-623-2809
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 07/08/2007

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