Basic Information
| Provider Information | |||||||||
| NPI: | 1982898383 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VICTOR E PAYTON MD, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3025 BRECKINRIDGE BLVD STE 120 | ||||||||
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| City: | DULUTH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300964979 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6782260082 | ||||||||
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| Practice Location | |||||||||
| Address1: | 700 OGLETHORPE AVE # 3 | ||||||||
| Address2: | |||||||||
| City: | ATHENS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 306062221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065483196 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2007 | ||||||||
| LastUpdateDate: | 08/29/2007 | ||||||||
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| AuthorizedOfficialLastName: | PAYTON | ||||||||
| AuthorizedOfficialFirstName: | VICTOR | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7065483196 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 018412 | GA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.