Provider Demographics
NPI:1255878484
Name:MELTON, FELTON L
Entity type:Individual
Prefix:MR
First Name:FELTON
Middle Name:L
Last Name:MELTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 CARNES RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-6204
Mailing Address - Country:US
Mailing Address - Phone:404-441-5171
Mailing Address - Fax:
Practice Address - Street 1:2805 CARNES RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-6204
Practice Address - Country:US
Practice Address - Phone:404-441-5171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health