Provider Demographics
NPI:1649262676
Name:MORGAN, JENNIFER K (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:K
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11725 N ILLINOIS ST STE 560
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032
Practice Address - Country:US
Practice Address - Phone:317-688-5250
Practice Address - Fax:317-688-5251
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059278A207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200077230Medicaid
INP01022581OtherRAILROAD MEDICARE PTAN
INP00146155OtherRAILROAD MEDICARE PTAN
IN200077230Medicaid
IN200077230Medicaid
INP00146155OtherRAILROAD MEDICARE PTAN
INM400056801Medicare PIN