Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MD022706 | LA |
NPI | 1053308163 |
---|---|
Provider Name | Dr. Rolf Daniel Morstead |
First Address | Monroe, LA 71210-1284 |
Second Address | Monroe, LA 71201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2005 |
Last Update Date | 19/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1492221 | (05) | LA |
H17408 | (02) |