Sulton, Jacqueline R

Sulton, Jacqueline R is an individual health care provider with primary practice located at 2258 Northlake Pkwy Suite 100, Tucker GA 30084-4019. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Sulton, Jacqueline R can be contacted via phone (770) 670-6100.

Contact Information

Primary practice address
2258 Northlake Pkwy Suite 100 Tucker GA 30084-4019
Phone: (770) 670-6100
Fax: (470) 359-5996
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 027675 Georgia

Profile Details

NPI number 1326031741
LBN Legal business name Sulton, Jacqueline R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated May 5th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326031741 NPPES
Georgia MEDICAID 000307304D

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