Provider Demographics
NPI:1003075003
Name:THE SULTON PEDIATRIC GROUP, PC
Entity Type:Organization
Organization Name:THE SULTON PEDIATRIC GROUP, PC
Other - Org Name:SULTON PEDIATRICS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:SULTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-670-6100
Mailing Address - Street 1:5700 HILLANDALE DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-4103
Mailing Address - Country:US
Mailing Address - Phone:770-670-6100
Mailing Address - Fax:678-990-1446
Practice Address - Street 1:5700 HILLANDALE DR
Practice Address - Street 2:SUITE 150
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-4103
Practice Address - Country:US
Practice Address - Phone:770-670-6100
Practice Address - Fax:678-990-1446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty