Provider Demographics
NPI:1114773371
Name:MORGAN, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1545
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74821-1545
Mailing Address - Country:US
Mailing Address - Phone:580-436-2690
Mailing Address - Fax:580-436-2695
Practice Address - Street 1:301 W 4TH ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-3411
Practice Address - Country:US
Practice Address - Phone:580-436-2690
Practice Address - Fax:580-436-2695
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator