Provider Demographics
NPI:1174843338
Name:MORSE, JONATHAN
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:MORSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MCKENNA BLVD
Mailing Address - Street 2:#2
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-6318
Mailing Address - Country:US
Mailing Address - Phone:608-669-1058
Mailing Address - Fax:
Practice Address - Street 1:1901 MCKENNA BLVD
Practice Address - Street 2:#2
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-6318
Practice Address - Country:US
Practice Address - Phone:608-669-1058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist