Provider Demographics
NPI:1437147451
Name:PITTS, DAVID B JR (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:PITTS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4245 JOHNS CREEK PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-9122
Mailing Address - Country:US
Mailing Address - Phone:678-990-3962
Mailing Address - Fax:678-623-3862
Practice Address - Street 1:4245 JOHNS CREEK PKWY STE A
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-9122
Practice Address - Country:US
Practice Address - Phone:678-990-3962
Practice Address - Fax:678-623-3862
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051415207Y00000X, 207YS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA334155399Medicaid
GA334155399Medicaid
GAF11843Medicare UPIN
GA202I138402Medicare Oscar/Certification