Provider Demographics
NPI:1376591495
Name:MIDDLETON, COURTNEY ELISE (MD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:ELISE
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:COURTNEY
Other - Middle Name:E
Other - Last Name:COLLINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5780 PEACHTREE DUNWOODY ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1513
Mailing Address - Country:US
Mailing Address - Phone:404-303-1224
Mailing Address - Fax:404-303-1325
Practice Address - Street 1:5400 LAUREL SPRINGS PKWY STE 1403
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6098
Practice Address - Country:US
Practice Address - Phone:770-282-4802
Practice Address - Fax:770-615-0659
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057295207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA686494265BMedicaid
GA686494265DMedicaid
GA686494265CMedicaid
GA686494265CMedicaid