Provider Demographics
NPI:1306524335
Name:TAYLOR, MORGAN E (OTC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OTC
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2419 OLD THOMPSON BRIDGE RD APT I09
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-1166
Mailing Address - Country:US
Mailing Address - Phone:478-297-6159
Mailing Address - Fax:404-352-7464
Practice Address - Street 1:2860 RONALD REAGAN BLVD STE 240
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6092
Practice Address - Country:US
Practice Address - Phone:404-355-0743
Practice Address - Fax:404-352-7464
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA16-0802156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist