1013964493 NPI number — CHAD J MORGAN M.D.

Table of content: CHAD J MORGAN M.D. (NPI 1013964493)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013964493 NPI number — CHAD J MORGAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORGAN
Provider First Name:
CHAD
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013964493
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9434
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65801-9434
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-885-3888
Provider Business Mailing Address Fax Number:
417-881-7638

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3801 S NATIONAL AVE
Provider Second Line Business Practice Location Address:
WEST TOWER, SUITE 700
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65807-5210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-885-3888
Provider Business Practice Location Address Fax Number:
417-881-7638
Provider Enumeration Date:
05/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X , with the licence number:  E-4936 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207T00000X , with the licence number: 2006005747 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2561113 . This is a "COX HEALTH PLANS UPI" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 5H031 . This is a "ARKANSAS BC/BS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 209237 . This is a "BLUE CROSS / CHOICE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 0600288 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 4188130001 . This is a "CIGNA MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 5H031 . This is a "ARKANSAS HEALTH ADVANTAGE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 0215051 . This is a "DEPARTMENT OF LABOR WA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 6874728001 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 776447 . This is a "HEALTHLINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 166615001 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201503307 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5H031 . This is a "ARKANSAS FIRST SOURCE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




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