Provider Demographics
NPI:1760557888
Name:MORGAN, JEFFERY CARL (MD)
Entity Type:Individual
Prefix:
First Name:JEFFERY
Middle Name:CARL
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6200 EXCELSIOR BLVD SUITE 202
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416
Mailing Address - Country:US
Mailing Address - Phone:952-548-9340
Mailing Address - Fax:952-548-9350
Practice Address - Street 1:6200 EXCELSIOR BLVD SUITE 202
Practice Address - Street 2:
Practice Address - City:ST. LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416
Practice Address - Country:US
Practice Address - Phone:952-548-9340
Practice Address - Fax:952-548-9350
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN26754207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine