Provider Demographics
NPI:1912111535
Name:MORGAN, RONALD JAY JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:JAY
Last Name:MORGAN
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 E 327TH ST
Mailing Address - Street 2:
Mailing Address - City:WILLOWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44095-3315
Mailing Address - Country:US
Mailing Address - Phone:440-943-0810
Mailing Address - Fax:
Practice Address - Street 1:10 E HIGH ST
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-3411
Practice Address - Country:US
Practice Address - Phone:440-354-1607
Practice Address - Fax:440-354-1877
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-001650363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant