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1750481982

NPI Code Detail

MEDICARE: DEKALB COUNTY BOARD OF HEALTH

MEDICARE: DEKALB 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	251X00000X	Supports Brokerage Agency		GA
2	251K00000X	Public Health or Welfare Agency		GA
3	261QF0400X	Federally Qualified Health Center (FQHC)		GA
4	163WC0400X	Case Management Registered Nurse		GA
5	251K00000X	Public Health or Welfare Agency

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750481982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEKALB COUNTY BOARD OF HEALTH

Provider Business Mailing Address
First Line	:	445 WINN WAY
Second Line	:	PO BOX 987
City	:	DECATUR
State	:	GA
Zip	:	30030-1707
Country	:	US
Telephone Number	:	404-294-3701
Fax Number	:	404-508-7862

Provider Business Practice Location Address
First Line	:	440 WINN WAY
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-1715
Country	:	US
Telephone Number	:	404-294-3762
Fax Number	:	404-508-7752

Authorized Official
Title or Position	:	DISTRICT DIRECTOR/CEO
Name	:	LYNN PAXTON
Credential	:	MD
Telephone Number	:	404-294-3787

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	05/27/2026

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Directions to “DEKALB COUNTY BOARD OF HEALTH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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