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General NPI Number Information
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NPI Number | 1760557888
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Entity Type | Individual
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Provider Name | JEFFERY CARL MORGAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 6200 EXCELSIOR BLVD SUITE 202
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City | ST. LOUIS PARK
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State | MN
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Zip | 55416
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Country | US
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Telephone | 952-548-9340
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Fax | 952-548-9350
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Provider Business Mailing Address
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Address Line | 6200 EXCELSIOR BLVD SUITE 202
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City | ST. LOUIS PARK
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State | MN
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Zip | 55416
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Country | US
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Telephone | 952-548-9340
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Fax | 952-548-9350
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 26754
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License Number State | MN
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