MEDICARE: JEFFREY GLENN MORGAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	01035453A	IN
2	207RG0100X	Gastroenterology Physician	01035453A	IN
3	207P00000X	Emergency Medicine Physician	01035453A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000062246	OTHER	IN	ANTHEM/BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447256334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY GLENN MORGAN MD

Provider Business Mailing Address
First Line	:	104 CONNIE AVE
Second Line	:
City	:	SALEM
State	:	IN
Zip	:	47167-2305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 CONNIE AVE
Second Line	:
City	:	SALEM
State	:	IN
Zip	:	47167-2305
Country	:	US
Telephone Number	:	812-883-2696
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	07/26/2022

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