Provider Demographics
NPI:1083673867
Name:SCHUESSLER, SUZANNE WRIGHT (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:WRIGHT
Last Name:SCHUESSLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 VERNON RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-4146
Mailing Address - Country:US
Mailing Address - Phone:706-883-6363
Mailing Address - Fax:706-884-5588
Practice Address - Street 1:1527 VERNON RD
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-4146
Practice Address - Country:US
Practice Address - Phone:706-883-6363
Practice Address - Fax:706-884-5588
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030541174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA85002467GMedicaid
AL009935280Medicaid
GA00364889CMedicaid
GA582557935OtherTAX ID
GA085352OtherBCBS
AL529909780Medicaid
AL009935280Medicaid