Provider Demographics
NPI:1467066167
Name:MORGESON, JORDAN ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:ELIZABETH
Last Name:MORGESON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:PINCKNEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62274-1344
Mailing Address - Country:US
Mailing Address - Phone:618-993-5686
Mailing Address - Fax:
Practice Address - Street 1:401 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:PINCKNEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62274-1344
Practice Address - Country:US
Practice Address - Phone:618-357-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046011469152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist