MEDICARE: FULTON COUNTY BOARD OF HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP0905X	State or Local Public Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962928903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FULTON COUNTY BOARD OF HEALTH

Provider Business Mailing Address
First Line	:	10 PARK PLACE SOUTH SE FL 4
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30303-2913
Country	:	US
Telephone Number	:	770-520-7500
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 MARTIN LUTHER KING JR DR SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-3674
Country	:	US
Telephone Number	:	770-520-7323
Fax Number	:

Authorized Official
Title or Position	:	DISTRICT HEALTH DIRECTOR
Name	:	DR. LYNN PAXTON
Credential	:	MD., M.P.H
Telephone Number	:	770-520-7489

Provider Enumeration Date	:	08/22/2017
Last Update Date	:	09/16/2024

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Directions to “FULTON COUNTY BOARD OF HEALTH ” Practice Location

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