Basic Information
Provider Information
NPI: 1750505913
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORGAN
FirstName: BENJAMIN
MiddleName: REID
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1687 E DIVISION ST
Address2:  
City: RIVER FALLS
State: WI
PostalCode: 540221571
CountryCode: US
TelephoneNumber: 7154256701
FaxNumber:  
Practice Location
Address1: 1687 E DIVISION ST
Address2:  
City: RIVER FALLS
State: WI
PostalCode: 540221571
CountryCode: US
TelephoneNumber: 7154256701
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/12/2007
LastUpdateDate: 05/09/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XE-6023ARY Allopathic & Osteopathic PhysiciansInternal Medicine 
207RN0300X60620WIN Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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