Provider Demographics
NPI:1619971686
Name:BURTON, DEBORAH M (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:M
Last Name:BURTON
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 1:2550 WINDY HILL RD SE
Mailing Address - Street 2:STE 307
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8665
Mailing Address - Country:US
Mailing Address - Phone:770-953-1414
Mailing Address - Fax:770-953-9474
Practice Address - Street 1:2550 WINDY HILL RD SE
Practice Address - Street 2:STE 307
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8665
Practice Address - Country:US
Practice Address - Phone:770-953-1414
Practice Address - Fax:770-953-9474
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039297174400000X, 207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000644344UMedicaid
GA00644344CMedicaid
GA000644344UMedicaid
GA00644344CMedicaid
GAF99860Medicare UPIN