Provider Demographics
NPI:1417995663
Name:MORRISON, DOUGLAS JAMES (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:JAMES
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 116301
Mailing Address - Street 2:PARAGON EMERGENCY PHYSICIANS PC
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-6301
Mailing Address - Country:US
Mailing Address - Phone:800-666-2455
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:1700 MEDICAL WAY
Practice Address - Street 2:EASTSIDE MEDICAL CENTER
Practice Address - City:SNELLVILEL
Practice Address - State:GA
Practice Address - Zip Code:30278
Practice Address - Country:US
Practice Address - Phone:770-736-2376
Practice Address - Fax:770-736-2379
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042093207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000763683KMedicaid
G66159Medicare UPIN
GA000763683KMedicaid