Healthcare Provider Details

I. General information

NPI: 1053417105
Provider Name (Legal Business Name): DEKALB COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3807 CLAIRMONT RD
CHAMBLEE GA
30341-4911
US

IV. Provider business mailing address

445 WINN WAY PO BOX 987
DECATUR GA
30030-1707
US

V. Phone/Fax

Practice location:
  • Phone: 770-454-1144
  • Fax: 770-452-4468
Mailing address:
  • Phone: 404-294-3701
  • Fax: 404-508-7862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: LYNN PAXTON
Title or Position: DISTRICT DIRECTOR/CEO
Credential: MD
Phone: 404-294-3787