Healthcare Provider Details

I. General information

NPI: 1508363136
Provider Name (Legal Business Name): MORGAN CAUGHLIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 04/06/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E MARSHALL AVE
LONGVIEW TX
75601
US

IV. Provider business mailing address

700 E MARSHALL AVE
LONGVIEW TX
75601-5580
US

V. Phone/Fax

Practice location:
  • Phone: 903-315-5171
  • Fax: 903-315-1888
Mailing address:
  • Phone: 903-315-5171
  • Fax: 903-315-1888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberT3753
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberBP10063796
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberT3753
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: