Healthcare Provider Details

I. General information

NPI: 1588231302
Provider Name (Legal Business Name): MORGAN PAUL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN SMEESTER

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 N WALNUT ST
NORTH MANCHESTER IN
46962-1857
US

IV. Provider business mailing address

605 N WALNUT ST
NORTH MANCHESTER IN
46962-1857
US

V. Phone/Fax

Practice location:
  • Phone: 260-982-1994
  • Fax: 260-479-2996
Mailing address:
  • Phone: 260-982-1994
  • Fax: 260-479-2996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01088055A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: