Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YP0228X | Pediatric Otolaryngology | 039297 | GA |
NPI | 1619971686 |
---|---|
Provider Name | Dr. Deborah M. Burton |
First Address | Marietta, GA 30067-8665 |
Second Address | Marietta, GA 30067-8665 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 11/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000644344U | (05) | GA |
00644344C | (05) | GA |
F99860 | (02) | GA |