Provider Demographics
NPI:1962264796
Name:LEEPER, MORGAN LYNN
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:LYNN
Last Name:LEEPER
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 1:209 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:QUAPAW
Mailing Address - State:OK
Mailing Address - Zip Code:74363-2966
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21 S EIGHT TRIBES TRAIL SUITE B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354
Practice Address - Country:US
Practice Address - Phone:918-387-8720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist