Provider Demographics
NPI:1558527127
Name:MORRISSEY, ANNIE QUINN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:QUINN
Last Name:MORRISSEY
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 1:2727 PACES FERRY RD SE STE 1-1100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6151
Mailing Address - Country:US
Mailing Address - Phone:470-271-3418
Mailing Address - Fax:
Practice Address - Street 1:1265 HIGHWAY 54 W STE 302
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4537
Practice Address - Country:US
Practice Address - Phone:770-506-1590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA081105207RE0101X
TN49750207RE0101X
390200000X
FLME126827207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIO633ZOtherMEDICARE
FLVS613OtherBCBS
FL017433100Medicaid
FLVS613OtherBCBS
MN110012957Medicare PIN
FLIO633ZMedicare UPIN
TN3710089Medicaid
MN110012957Medicare PIN
FLIO633ZMedicare UPIN