Provider Demographics
NPI:1326498726
Name:MANCHESTER, MORGAN TERRY (MD)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:TERRY
Last Name:MANCHESTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:TM
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1201 GRAMPIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1900
Mailing Address - Country:US
Mailing Address - Phone:570-326-8723
Mailing Address - Fax:
Practice Address - Street 1:1205 GRAMPIAN BLVD STE 3C
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-1970
Practice Address - Country:US
Practice Address - Phone:570-320-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD467331207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine