Provider Demographics
NPI:1447299706
Name:MORGAN, LINDA JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JEAN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:JEAN
Other - Last Name:MORGAN-EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:881 OLD ROUTE 66 BLDG 3C
Mailing Address - Street 2:
Mailing Address - City:ST ROBERTS
Mailing Address - State:MO
Mailing Address - Zip Code:65584-3732
Mailing Address - Country:US
Mailing Address - Phone:855-420-7900
Mailing Address - Fax:
Practice Address - Street 1:881 OLD ROUTE 66, 3C
Practice Address - Street 2:
Practice Address - City:ST ROBERTS
Practice Address - State:MO
Practice Address - Zip Code:65584-3732
Practice Address - Country:US
Practice Address - Phone:573-336-3644
Practice Address - Fax:888-831-8225
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO111945207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207571506Medicaid
MO207571506Medicaid
MO207571506Medicaid
MOG73259Medicare UPIN
MO908583230Medicare PIN