Provider Demographics
NPI:1992851604
Name:BURTON, MANLEY FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:MANLEY
Middle Name:FRANCIS
Last Name:BURTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5 HURRICANE SHOALS RD NE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4561
Mailing Address - Country:US
Mailing Address - Phone:678-376-6555
Mailing Address - Fax:678-376-6564
Practice Address - Street 1:5 HURRICANE SHOALS RD NE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4561
Practice Address - Country:US
Practice Address - Phone:678-376-6555
Practice Address - Fax:678-376-6564
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022983207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAC13984Medicare UPIN