Provider Demographics
NPI:1124115480
Name:MORTON, HARRY W (PT)
Entity type:Individual
Prefix:MR
First Name:HARRY
Middle Name:W
Last Name:MORTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 JOHN HARDEN DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-3775
Mailing Address - Country:US
Mailing Address - Phone:501-982-9511
Mailing Address - Fax:501-982-9512
Practice Address - Street 1:208 JOHN HARDEN DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-3775
Practice Address - Country:US
Practice Address - Phone:501-982-9511
Practice Address - Fax:501-982-9512
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR727225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR56082OtherARBCBS
AR56082OtherARBCBS
AR56082OtherARBCBS