Provider Demographics
NPI:1225133226
Name:MORGAN, FREDERICK B (DO)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:B
Last Name:MORGAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 COURTHOUSE ROAD
Mailing Address - Street 2:311 COURTHOUSE ROAD
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740
Mailing Address - Country:US
Mailing Address - Phone:304-487-2297
Mailing Address - Fax:304-487-4802
Practice Address - Street 1:311 COURTHOUSE ROAD
Practice Address - Street 2:311 COURTHOUSE ROAD
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740
Practice Address - Country:US
Practice Address - Phone:304-487-2297
Practice Address - Fax:304-487-4802
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1596207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0098560000Medicaid
WV4730300001Medicare NSC
WVG57489Medicare UPIN
WV9330321Medicare ID - Type Unspecified