Provider Demographics
NPI:1093998346
Name:MUSE, JESSIE LOUISE (MD)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:LOUISE
Last Name:MUSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:MUSE
Other - Last Name:AL-AMIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:3300 MEMORIAL DR
Mailing Address - Street 2:SUITE C1
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-2700
Mailing Address - Country:US
Mailing Address - Phone:678-732-9087
Mailing Address - Fax:678-732-9088
Practice Address - Street 1:3300 MEMORIAL DR
Practice Address - Street 2:SUITE C1
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-2700
Practice Address - Country:US
Practice Address - Phone:678-732-9087
Practice Address - Fax:678-732-9088
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-10
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033395208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice