Provider Demographics
NPI:1437144193
Name:ALBRITTON, MARK J (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:ALBRITTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:105 REGENCY PARK DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-6649
Mailing Address - Country:US
Mailing Address - Phone:770-506-4119
Mailing Address - Fax:770-506-4145
Practice Address - Street 1:105 REGENCY PARK DR
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-6649
Practice Address - Country:US
Practice Address - Phone:770-506-4119
Practice Address - Fax:770-506-4145
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055912207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA254767158DMedicaid
GA254767158EMedicaid
GA254767158AMedicaid
GA254767158GMedicaid
GA254767158CMedicaid
GA254767158AMedicaid
GA254767158CMedicaid