Healthcare Provider Details

I. General information

NPI: 1083702252
Provider Name (Legal Business Name): MATTHEW JAMES BRITTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 STATE BRIDGE ROAD SUITE 240
DULUTH GA
30097
US

IV. Provider business mailing address

5955 STATE BRIDGE ROAD SUITE 240
DULUTH GA
30097
US

V. Phone/Fax

Practice location:
  • Phone: 770-368-8702
  • Fax: 770-368-8727
Mailing address:
  • Phone: 770-368-8702
  • Fax: 770-368-8727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number026067
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: