Provider Demographics
NPI:1780176305
Name:MURAIDA, JORIE (DO)
Entity type:Individual
Prefix:
First Name:JORIE
Middle Name:
Last Name:MURAIDA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:GA
Mailing Address - Zip Code:30628-0459
Mailing Address - Country:US
Mailing Address - Phone:706-788-3234
Mailing Address - Fax:706-788-2936
Practice Address - Street 1:11 CHARLIE MORRIS RD
Practice Address - Street 2:
Practice Address - City:COLBERT
Practice Address - State:GA
Practice Address - Zip Code:30628-2445
Practice Address - Country:US
Practice Address - Phone:706-788-2127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-11149208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics