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Individual

MICHAEL LEE BURTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
400 TOWER ROAD, SUITE 200, MARIETTA, GA 30060
(770) 514-7550
(770) 514-1390
Mailing address
PO BOX 102321, ATLANTA, GA 30368-2321
(770) 801-2500
(770) 803-2121

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006815
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003148046A
GA
01
20297I1312
MEDICARE
GA
Enumeration date
06/10/2013
Last updated
11/03/2014
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