Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 6729 | NV |
NPI | 1104864073 |
---|---|
Provider Name | Jay K Morgan |
First Address | Reno, NV 89511-3019 |
Second Address | Reno, NV 89511-3019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 10/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002016465 | (05) | NV |
880167036A010 | TRICARE (01) | NV |
CC2263 | BC/BS (01) | NV |
E15219 | (02) | NV |
XPY166210 | (05) | CA |