Basic Information
Provider Information
NPI: 1548641376
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEST
FirstName: MORGAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13606 W MONTEREY WAY
Address2:  
City: AVONDALE
State: AZ
PostalCode: 853926794
CountryCode: US
TelephoneNumber: 5166538580
FaxNumber:  
Practice Location
Address1: 13471 W CORNERSTONE BLVD
Address2:  
City: GOODYEAR
State: AZ
PostalCode: 85395
CountryCode: US
TelephoneNumber: 8778095092
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/17/2015
LastUpdateDate: 07/24/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X007980AZY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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