Basic Information
| Provider Information | |||||||||
| NPI: | 1518962703 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SACKS | ||||||||
| FirstName: | HARVEY | ||||||||
| MiddleName: | NORTON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 55 WHITCHER ST NE | ||||||||
| Address2: | SUITE 350 | ||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300601155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704246893 | ||||||||
| FaxNumber: | 7705289938 | ||||||||
| Practice Location | |||||||||
| Address1: | 148 BILL CARRUTH PKWY STE 4200 | ||||||||
| Address2: | |||||||||
| City: | HIRAM | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301413754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6783244444 | ||||||||
| FaxNumber: | 7705289932 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2005 | ||||||||
| LastUpdateDate: | 12/02/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 017880 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 000153106P | 05 | GA | MEDICAID | 000153106O | 05 | GA | MEDICAID | 000153106R | 05 | GA | MEDICAID | 000153106Q | 05 | GA | MEDICAID | 000153106M | 05 | GA | MEDICAID | 000153106N | 05 | GA | MEDICAID |