Provider Demographics
NPI:1053918896
Name:LOTT, MORGAN AILEEN (PT, DPT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:AILEEN
Last Name:LOTT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5532 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-6708
Mailing Address - Country:US
Mailing Address - Phone:501-588-3211
Mailing Address - Fax:
Practice Address - Street 1:920 CEDAR LAKE RD
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2124
Practice Address - Country:US
Practice Address - Phone:228-641-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT0001225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR251741721Medicaid