Sondralyn M Fackler, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

044211 Issued in GA

Practice address

125 Plantation Centre Dr S
BLDG. 600 Suite B
Macon, GA 31210-2079

Phone

(478) 474-6467

Fax

(478) 474-6407

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881814820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PLANTATION CENTRE DR S",
            "address_2": "BLDG. 600 SUITE B",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102079",
            "telephone_number": "478-474-6467",
            "fax_number": "478-474-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PLANTATION CENTRE DR S",
            "address_2": "BLDG. 600 SUITE B",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102079",
            "telephone_number": "478-474-6467",
            "fax_number": "478-474-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACKLER",
        "first_name": "SONDRALYN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "044211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eye Physicians Professional Association
• Harry Onoriode Eyituoyo, MD
• Chioma Eze-Njoku
• Ngozi Iheuwa Ezeh, MD, RPA-C
• Christian M Ezekwueche, MD
• William Keith Fackler, MD
• Fadoul Medical LLC
• Peter Sami Fadoul, MD
• Catherine Faircloth, NP
• Jennifer Simmons Faircloth, CRNA

• Psychiatry Physician in Macon, GA
• Providers in Macon, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.