Provider Demographics
NPI:1518962703
Name:SACKS, HARVEY NORTON (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:NORTON
Last Name:SACKS
Suffix:
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 1:55 WHITCHER ST NE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1155
Mailing Address - Country:US
Mailing Address - Phone:770-424-6893
Mailing Address - Fax:770-528-9938
Practice Address - Street 1:148 BILL CARRUTH PKWY STE 4200
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-3754
Practice Address - Country:US
Practice Address - Phone:678-324-4444
Practice Address - Fax:770-528-9932
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017880207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000153106PMedicaid
GA000153106OMedicaid
GA000153106RMedicaid
GA000153106QMedicaid
GA000153106MMedicaid
GA000153106NMedicaid
GA511I060366Medicare PIN
D41027Medicare UPIN
GA000153106RMedicaid