Provider Demographics
NPI:1417142985
Name:MATTHEW J. BRITTON, M.D., P.C.
Entity Type:Organization
Organization Name:MATTHEW J. BRITTON, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-368-8702
Mailing Address - Street 1:5955 STATE BRIDGE RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8208
Mailing Address - Country:US
Mailing Address - Phone:770-368-8702
Mailing Address - Fax:770-368-8727
Practice Address - Street 1:5955 STATE BRIDGE RD
Practice Address - Street 2:SUITE 240
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-8208
Practice Address - Country:US
Practice Address - Phone:770-368-8702
Practice Address - Fax:770-368-8727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA26067177F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes177F00000XOther Service ProvidersLodgingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1083702252OtherNPI
GAC02774Medicare UPIN
GA08BDBQWMedicare PIN