Provider Demographics
NPI:1982898383
Name:VICTOR E PAYTON MD, PC
Entity Type:Organization
Organization Name:VICTOR E PAYTON MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-548-3196
Mailing Address - Street 1:3025 BRECKINRIDGE BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4979
Mailing Address - Country:US
Mailing Address - Phone:678-226-0082
Mailing Address - Fax:
Practice Address - Street 1:700 OGLETHORPE AVE # 3
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2221
Practice Address - Country:US
Practice Address - Phone:706-548-3196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA018412208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty