Provider Demographics
NPI:1629886395
Name:NAUGHTON, JOHN DANIEL
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:DANIEL
Last Name:NAUGHTON
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 1:3300 BUCKEYE RD STE 178
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-4232
Mailing Address - Country:US
Mailing Address - Phone:770-458-6101
Mailing Address - Fax:770-455-4008
Practice Address - Street 1:3300 BUCKEYE RD STE 178
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4232
Practice Address - Country:US
Practice Address - Phone:770-458-6101
Practice Address - Fax:770-455-4008
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA246Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology