Basic Information
Provider Information
NPI: 1932425345
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORGAN
FirstName: JAYSON
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1155 MILL ST # MCM14
Address2:  
City: RENO
State: NV
PostalCode: 895021576
CountryCode: US
TelephoneNumber: 7598252627
FaxNumber: 7759825496
Practice Location
Address1: 1500 E 2ND ST STE 400
Address2:  
City: RENO
State: NV
PostalCode: 895021198
CountryCode: US
TelephoneNumber: 7759822400
FaxNumber: 7759822888
Other Information
ProviderEnumerationDate: 04/09/2010
LastUpdateDate: 12/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/22/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X16954NVY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


Home