Provider Demographics
NPI:1386026466
Name:MORGAN, ELIZABETH HALE (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:HALE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1929 S SCENIC AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-2153
Mailing Address - Country:US
Mailing Address - Phone:479-799-5283
Mailing Address - Fax:
Practice Address - Street 1:1520 E BATES
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-8425
Practice Address - Country:US
Practice Address - Phone:417-222-3395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-11248207Q00000X
NV22189207Q00000X
MO2024041690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1386026466Medicaid
NV22189OtherSTATE LICENSE