Provider Demographics
NPI:1861974750
Name:MORTON, HAYLEY ANITA (PA-C)
Entity type:Individual
Prefix:MS
First Name:HAYLEY
Middle Name:ANITA
Last Name:MORTON
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:531 ROSELANE ST NW STE 710
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6975
Mailing Address - Country:US
Mailing Address - Phone:678-331-3297
Mailing Address - Fax:678-581-7187
Practice Address - Street 1:144 BILL CARRUTH PKWY STE 3100
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-3819
Practice Address - Country:US
Practice Address - Phone:678-363-1940
Practice Address - Fax:678-581-7110
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2020-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA009067363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1861974750OtherNPI NUMBER