Provider Demographics
NPI:1487789145
Name:DORSETT, MORGAN C (DC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:C
Last Name:DORSETT
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 1:511 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:SD
Mailing Address - Zip Code:57274-1718
Mailing Address - Country:US
Mailing Address - Phone:605-345-6222
Mailing Address - Fax:605-345-6224
Practice Address - Street 1:511 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:SD
Practice Address - Zip Code:57274-1718
Practice Address - Country:US
Practice Address - Phone:605-345-6222
Practice Address - Fax:605-345-6224
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1001111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7601630Medicaid
SD7601630Medicaid