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General NPI Number Information
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NPI Number | 1174432066
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Entity Type | Individual
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Provider Name | MORGAN DIEBOLD
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Gender | Female
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 2968 N HIGHLAND AVE
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City | JACKSON
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State | TN
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Zip | 38305-3409
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Country | US
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Telephone | 731-256-1819
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Fax | 731-664-4330
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Provider Business Mailing Address
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Address Line | 267 HILLCREST DR
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City | HUNTINGDON
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State | TN
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Zip | 38344-1501
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 237702
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License Number State | TN
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