Healthcare Provider Details

I. General information

NPI: 1164436309
Provider Name (Legal Business Name): LORIE JANE MORGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 04/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2859 STATE ST SUITE 102
MEDFORD OR
97504-8400
US

IV. Provider business mailing address

2620 E BARNETT RD STE H
MEDFORD OR
97504-8383
US

V. Phone/Fax

Practice location:
  • Phone: 541-282-6518
  • Fax: 541-282-6510
Mailing address:
  • Phone: 541-789-4281
  • Fax: 541-789-3558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD18924
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: