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General NPI Number Information
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NPI Number | 1740454255
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Entity Type | Organization
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Legal Business Name | MOREHOUSE SCHOOL OF MEDICINE
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 720 WESTVIEW DR SW
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City | ATLANTA
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State | GA
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Zip | 30310-1458
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Country | US
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Telephone | 404-756-1857
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Fax |
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Provider Business Mailing Address
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Address Line | 720 WESTVIEW DR SW
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City | ATLANTA
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State | GA
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Zip | 30310-1458
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR
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Name | COYEA KIZZIE
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Credential |
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Telephone | 404-752-1857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 001974
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License Number State | GA
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