Provider Demographics
NPI:1992875058
Name:MORGAN, TERRY DOUGLAS (DC)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:DOUGLAS
Last Name:MORGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5558 CALIFORNIA AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0710
Mailing Address - Country:US
Mailing Address - Phone:661-633-2134
Mailing Address - Fax:661-633-2124
Practice Address - Street 1:5558 CALIFORNIA AVE STE 420
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0710
Practice Address - Country:US
Practice Address - Phone:661-633-2134
Practice Address - Fax:661-633-2124
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 24116111N00000X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC 24116OtherINSURACE PURPOSE
CADC 24116OtherINSURACE PURPOSE
CAU72233Medicare UPIN