Charles Barton, CSA

Individual provider Active NPI Medical Physician Assistant · Lithonia, GA

NPI 1649467473 · NPPES record last updated Sep 25, 2007

Key facts

NPI
1649467473
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
84589 (GA)
Practice address
5868 Fairington Farms LN
Lithonia, GA 30038-1544
Phone
(770) 985-4257
Fax
(770) 985-4258
NPI assigned
Sep 25, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 84589 GA Yes

Addresses

Primary practice location

5868 Fairington Farms LN
Lithonia, GA 30038-1544

Mailing address

5868 Fairington Farms LN
Lithonia, GA 30038-1544
Phone (770) 985-4257

Other providers in Lithonia, GA

All providers in Lithonia, GA · Medical Physician Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.