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Individual

JASON WADE MORGENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
903 S 12TH ST, ROCKY FORD, CO 81067-2127
(719) 254-7623
(719) 254-5112
Mailing address
903 S 12TH ST, ROCKY FORD, CO 81067-2127
(719) 254-7623
(719) 254-5112

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44697
CO
207V00000X
Obstetrics & Gynecology Physician
44697
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
76372766
CO
Enumeration date
09/16/2006
Last updated
06/10/2011
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