Provider Demographics
NPI:1750834453
Name:DIEKER, MORGAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:DIEKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 E MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66749-3330
Mailing Address - Country:US
Mailing Address - Phone:620-365-3176
Mailing Address - Fax:620-365-5111
Practice Address - Street 1:109 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-3330
Practice Address - Country:US
Practice Address - Phone:620-365-3176
Practice Address - Fax:620-365-5111
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS16939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist