Provider Demographics
NPI:1457346660
Name:PALMER, SUZANNE JEANETTE (MD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:JEANETTE
Last Name:PALMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 N COBB ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-2390
Mailing Address - Country:US
Mailing Address - Phone:478-453-8511
Mailing Address - Fax:478-452-5458
Practice Address - Street 1:750 N COBB ST
Practice Address - Street 2:SUITE 240
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2390
Practice Address - Country:US
Practice Address - Phone:478-453-8511
Practice Address - Fax:478-452-5458
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA25007207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000270355AMedicaid
D40797Medicare UPIN