Provider Demographics
NPI:1619927878
Name:COTTON, BYRON C (MD, FAAP)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:C
Last Name:COTTON
Suffix:
Gender:M
Credentials:MD, FAAP
Other - Prefix:DR
Other - First Name:BYRON
Other - Middle Name:CEDRIC
Other - Last Name:COTTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, FAAP
Mailing Address - Street 1:2785 LAWRENCEVILLE HWY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2515
Mailing Address - Country:US
Mailing Address - Phone:770-621-0245
Mailing Address - Fax:
Practice Address - Street 1:2785 LAWRENCEVILLE HWY
Practice Address - Street 2:STE 207
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-2515
Practice Address - Country:US
Practice Address - Phone:770-621-0245
Practice Address - Fax:770-621-0819
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0410982080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000679731NMedicaid