Basic Information
| Provider Information | |||||||||
| NPI: | 1508057134 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LESTER | ||||||||
| FirstName: | SUZANNE | ||||||||
| MiddleName: | HAMILTON | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 161463 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303211463 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063695440 | ||||||||
| FaxNumber: | 7063695490 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 OGLETHORPE AVE | ||||||||
| Address2: | STE 600E | ||||||||
| City: | ATHENS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 306062179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065482133 | ||||||||
| FaxNumber: | 7065487153 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2007 | ||||||||
| LastUpdateDate: | 05/11/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 059454 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.