Provider Demographics
NPI:1861602443
Name:MORGAN, THEODORE II (MD)
Entity type:Individual
Prefix:
First Name:THEODORE
Middle Name:
Last Name:MORGAN
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 HIGHLANDS PKWY SE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-5166
Mailing Address - Country:US
Mailing Address - Phone:678-388-0946
Mailing Address - Fax:844-452-7877
Practice Address - Street 1:3200 HIGHLANDS PKWY SE
Practice Address - Street 2:SUITE 400
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-5166
Practice Address - Country:US
Practice Address - Phone:678-388-0946
Practice Address - Fax:844-452-7877
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA657112084P0804X, 2084P0800X, 2084P0804X
AL286652084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry