Provider Demographics
NPI:1902806177
Name:MORGAN, JAMIE LEE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:LEE
Last Name:MORGAN
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:60 COMMERCE PLAZA CIR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-7386
Mailing Address - Country:US
Mailing Address - Phone:910-521-2900
Mailing Address - Fax:910-775-9165
Practice Address - Street 1:307 E WARDELL DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-7998
Practice Address - Country:US
Practice Address - Phone:910-521-2816
Practice Address - Fax:910-521-3583
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2020-09-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC103851363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8101256Medicaid
NC8101256Medicaid