Basic Information
| Provider Information | |||||||||
| NPI: | 1093749673 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORGAN | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 N COLLEGE ST | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 360372025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3343822681 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6980 WINTON BLOUNT BLVD | ||||||||
| Address2: | |||||||||
| City: | MONTGOMERY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 361173556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3342770484 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 05/10/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 12754 | AL | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 00122955 | 01 | MS | MISSISSIPPI MEDICAID | OTHER | 009984620 | 05 | AL | MEDICAID | 009937061 | 05 | AL | MEDICAID | 000084840 | 01 | AL | BLUE CROSS | OTHER | 000084840 | 05 | AL | MEDICAID | 051088721 | 01 | AL | BLUE CROSS | OTHER | 14306 | 01 | AL | HEALTHSPRING OF ALABAMA | OTHER | C71256 | 01 | AL | VIVA | OTHER | 009909465 | 05 | AL | MEDICAID | 051506482 | 01 | AL | BLUE CROSS | OTHER | 051518007 | 01 | AL | BLUE CROSS | OTHER |