Provider Demographics
NPI:1679595128
Name:MORGAN, JOE W (DO)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:W
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 1:8556 WOODLAND ROSE CIR N
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-8554
Mailing Address - Country:US
Mailing Address - Phone:731-215-7047
Mailing Address - Fax:
Practice Address - Street 1:8556 WOODLAND ROSE CIR N
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-8554
Practice Address - Country:US
Practice Address - Phone:731-215-7047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0085207Q00000X
FLOS3199207W00000X
TNDO0085207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I080976OtherPTAN TENNESSEE
FLAF877YOtherPTAN FLORIDA
TNBO4885Medicare UPIN