Healthcare Provider Details

I. General information

NPI: 1124550272
Provider Name (Legal Business Name): JESSE JAMES MORRISON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON ROAD
ATLANTA GA
30332-7232
US

IV. Provider business mailing address

121 RIDLEY LN
DECATUR GA
30030-2910
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-3900
  • Fax:
Mailing address:
  • Phone: 601-431-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number92305
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number92305
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: