Healthcare Provider Details

I. General information

NPI: 1083673867
Provider Name (Legal Business Name): SUZANNE WRIGHT SCHUESSLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 VERNON RD
LAGRANGE GA
30240-4146
US

IV. Provider business mailing address

1527 VERNON RD
LAGRANGE GA
30240-4146
US

V. Phone/Fax

Practice location:
  • Phone: 706-883-6363
  • Fax: 706-884-5588
Mailing address:
  • Phone: 706-883-6363
  • Fax: 706-884-5588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number030541
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: