Provider Demographics
NPI:1508057134
Name:LESTER, SUZANNE HAMILTON (MD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:HAMILTON
Last Name:LESTER
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:PO BOX 161463
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30321-1463
Mailing Address - Country:US
Mailing Address - Phone:706-369-5440
Mailing Address - Fax:706-369-5490
Practice Address - Street 1:1500 OGLETHORPE AVE
Practice Address - Street 2:STE 600E
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2179
Practice Address - Country:US
Practice Address - Phone:706-548-2133
Practice Address - Fax:706-548-7153
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059454207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
511I080167Medicare PIN