Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 4301114204 | MI |
Y | 207Q00000X | Family Doctor | T1783 | TX |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 4301114204 | MI |
N | 207QG0300X | Family Doctor - Geriatric Medicine | T1783 | TX |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | T1783 | TX |
NPI | 1669867461 |
---|---|
Provider Name | Jared Morphew |
First Address | Durham, NC 27710-0001 |
Second Address | Dallas, TX 75390-2700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 02/06/2021 |