Provider Demographics
NPI:1639406218
Name:MORGAN, JERRY FRANKLIN JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:JERRY
Middle Name:FRANKLIN
Last Name:MORGAN
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 SANDERSON LN
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:AR
Mailing Address - Zip Code:71854-8169
Mailing Address - Country:US
Mailing Address - Phone:870-774-7065
Mailing Address - Fax:
Practice Address - Street 1:7411 SANDERSON LN
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-8169
Practice Address - Country:US
Practice Address - Phone:870-774-7065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29706183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist