Provider Demographics
NPI:1447313291
Name:MORTON HOSPITALISTS AND INTERNAL MEDICINE
Entity type:Organization
Organization Name:MORTON HOSPITALISTS AND INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LASONGIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-396-6033
Mailing Address - Street 1:PO BOX 2224
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30061-2224
Mailing Address - Country:US
Mailing Address - Phone:770-425-4350
Mailing Address - Fax:770-425-4365
Practice Address - Street 1:50 PLAZA WAY NW
Practice Address - Street 2:SUITE D
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1141
Practice Address - Country:US
Practice Address - Phone:770-425-4350
Practice Address - Fax:770-425-4365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046185261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6396Medicare ID - Type Unspecified