Provider Demographics
NPI:1912513086
Name:SCHALLER, MORGAN RENEE (OD)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:RENEE
Last Name:SCHALLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 S LONGBRANCH DR
Mailing Address - Street 2:
Mailing Address - City:MAIZE
Mailing Address - State:KS
Mailing Address - Zip Code:67101-7019
Mailing Address - Country:US
Mailing Address - Phone:620-255-4180
Mailing Address - Fax:
Practice Address - Street 1:216 N MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-5119
Practice Address - Country:US
Practice Address - Phone:316-283-1310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2130152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist