Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD00017276 | WA |
NPI | 1619941309 |
---|---|
Provider Name | Dr. Philip R Morgan |
First Address | Walla Walla, WA 99362-4445 |
Second Address | Walla Walla, WA 99362 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 27/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
256032 | (05) | OR |
30233 | L&I (01) | WA |
40004875 | RAIL ROAD MEDICARE (01) | WA |
8170805 | (05) | WA |
A22702 | (02) | WA |