Individual
CARL RANDOLPH MORGAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
280 VIRGINIA AVE NE, SUITE 107, NORTON, VA 24273-1538
(276) 679-5390
(276) 679-5395
Mailing address
105 W STONE DR, SUITE 6A, KINGSPORT, TN 37660-3365
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004384
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255752069
—
VA
05
—
Q003803
—
TN
Enumeration date
12/20/2013
Last updated
10/24/2014
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