Healthcare Provider Details

I. General information

NPI: 1215005053
Provider Name (Legal Business Name): JULIAN DOUGLAS SHARPTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

891 CHURCH STREET
ROYSTON GA
30662
US

IV. Provider business mailing address

891 CHURCH STREET
ROYSTON GA
30662
US

V. Phone/Fax

Practice location:
  • Phone: 706-245-8081
  • Fax: 706-245-8977
Mailing address:
  • Phone: 706-245-8081
  • Fax: 706-245-8977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number017084
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: