Provider Demographics
NPI:1235181884
Name:SUMNER, CYNTHIA L (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:SUMNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-3490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 HARTFORD RD W STE 1
Practice Address - Street 2:
Practice Address - City:FORT GAINES
Practice Address - State:GA
Practice Address - Zip Code:39851-4331
Practice Address - Country:US
Practice Address - Phone:229-210-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA57685207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine