Provider Demographics
NPI:1972896397
Name:MOREHOUSE SCHOOL OF MEDICINE
Entity Type:Organization
Organization Name:MOREHOUSE SCHOOL OF MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR, GME
Authorized Official - Prefix:MS
Authorized Official - First Name:COYEA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIZZIE
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:404-752-1857
Mailing Address - Street 1:720 WESTVIEW DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-1458
Mailing Address - Country:US
Mailing Address - Phone:404-752-1857
Mailing Address - Fax:404-756-1313
Practice Address - Street 1:720 WESTVIEW DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-1458
Practice Address - Country:US
Practice Address - Phone:404-752-1857
Practice Address - Fax:404-756-1313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001974282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access