Individual
GARY PAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R. PH.
Contact information
Practice address
4948 TARRY GLEN DR, SUWANEE, GA 30024-7567
(678) 895-8905
Mailing address
4948 TARRY GLEN DR, SUWANEE, GA 30024-7567
(678) 895-8905
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
015397
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015397
BOARD OF PHARMACY
GA
Enumeration date
04/06/2020
Last updated
04/06/2020
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