Provider Demographics
NPI:1609181072
Name:MORGAN, JOHN RIDGEWAY IV (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:RIDGEWAY
Last Name:MORGAN
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:RIDGEWAY
Other - Last Name:MORGAN
Other - Suffix:IV
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5766 NW 112TH PSGE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3855
Mailing Address - Country:US
Mailing Address - Phone:305-710-3605
Mailing Address - Fax:
Practice Address - Street 1:3663 S. MIAMI AVE, SUITE 6603
Practice Address - Street 2:MERCY HOSPITAL
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133
Practice Address - Country:US
Practice Address - Phone:305-285-2792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHSE20577208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist