Provider Demographics
NPI:1063643476
Name:MCGEE, SUSAN R (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:R
Last Name:MCGEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:R
Other - Last Name:ATKINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:713 LOMAX AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:MS
Mailing Address - Zip Code:39367-2556
Mailing Address - Country:US
Mailing Address - Phone:601-671-2400
Mailing Address - Fax:601-671-2405
Practice Address - Street 1:713 LOMAX AVE
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:MS
Practice Address - Zip Code:39367-2556
Practice Address - Country:US
Practice Address - Phone:601-671-2400
Practice Address - Fax:601-671-2405
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306984208000000X
MS20758208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics