Provider Demographics
NPI:1770725442
Name:MOREHEAD, ROY LEE JR (CLS,ASCP,NCA,MPH)
Entity type:Individual
Prefix:PROF
First Name:ROY
Middle Name:LEE
Last Name:MOREHEAD
Suffix:JR
Gender:M
Credentials:CLS,ASCP,NCA,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-4019
Mailing Address - Country:US
Mailing Address - Phone:970-565-4441
Mailing Address - Fax:
Practice Address - Street 1:801 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-4019
Practice Address - Country:US
Practice Address - Phone:970-565-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician