Healthcare Provider Details

I. General information

NPI: 1760833503
Provider Name (Legal Business Name): JARRAD WILLIAM MORGAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2016
Last Update Date: 06/26/2020
Certification Date: 06/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8303 PLATT RD
SALINE MI
48176-9773
US

IV. Provider business mailing address

PO BOX 2060
ANN ARBOR MI
48106-2060
US

V. Phone/Fax

Practice location:
  • Phone: 734-429-2531
  • Fax:
Mailing address:
  • Phone: 734-295-4228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5151010022
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5101022778
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5315077797
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5101025456
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: