MEDICARE: DR. JALESSA JONELLE GRAHAM-HUDGINS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	100969	GA

General Provider Information

NPI Number	:	1316528805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JALESSA JONELLE GRAHAM-HUDGINS MD

Provider Business Mailing Address
First Line	:	GRADUATE MEDICAL EDUCATION OFFICE
Second Line	:	185 DUNAGAN COURT
City	:	WINDER
State	:	GA
Zip	:	30680
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6115 PEACHTREE DUNWOODY RD STE 350
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-5699
Country	:	US
Telephone Number	:	678-320-3610
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2021
Last Update Date	:	10/07/2024

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