Provider Demographics
NPI:1700805520
Name:MORGAN, STEPHANIE M (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:307 E MEIGHAN BLVD
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1048
Mailing Address - Country:US
Mailing Address - Phone:256-543-2273
Mailing Address - Fax:256-543-2293
Practice Address - Street 1:307 E MEIGHAN BLVD
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1048
Practice Address - Country:US
Practice Address - Phone:256-543-2273
Practice Address - Fax:256-543-2293
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24858207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051557529Medicaid
AL541388608Medicaid
AL051542398OtherBLUE CROSS
AL541388608Medicaid
ALH82663Medicare UPIN