Provider Demographics
NPI:1205815016
Name:MORGAN, BENJAMIN B (PA-C)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:B
Last Name:MORGAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1824 MURDOCH AVE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3230
Mailing Address - Country:US
Mailing Address - Phone:304-424-4760
Mailing Address - Fax:304-424-4761
Practice Address - Street 1:1824 MURDOCH AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3230
Practice Address - Country:US
Practice Address - Phone:304-424-4760
Practice Address - Fax:304-424-4761
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV734363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVMOPA22891Medicare ID - Type Unspecified