Individual
E ALLEN MORGAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5665 PEACHTREE DUNWOODY RD NE, SUITE 150, ATLANTA, GA 30342-1764
(404) 252-6104
(404) 257-1808
Mailing address
1838 AMERICAN WAY, LAWRENCEVILLE, GA 30043-6611
(770) 995-7622
(770) 995-7854
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
999
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003108479B
—
GA
05
—
191466194A
—
GA
01
—
242720
BCBS EDI
GA
01
—
970002275
RR MEDICARE
GA
Enumeration date
04/21/2006
Last updated
03/27/2013
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