Healthcare Provider Details

I. General information

NPI: 1891016986
Provider Name (Legal Business Name): TRENT MORGAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2010
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4881 SUGAR MAPLE DR EMERGENCY SERVICES
WRIGHT PATTERSON AFB OH
45433-5529
US

IV. Provider business mailing address

510 ARLINGTON DR
FRANKLIN OH
45005-1586
US

V. Phone/Fax

Practice location:
  • Phone: 317-408-8819
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number01070626A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.125649
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: