Provider Demographics
NPI:1699705228
Name:CARLTON, DAVID WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:WILLIAM
Last Name:CARLTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 ROBERTS DR STE 450
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-4115
Mailing Address - Country:US
Mailing Address - Phone:770-485-3723
Mailing Address - Fax:678-803-6944
Practice Address - Street 1:14 RIVERBEND DR SW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-6066
Practice Address - Country:US
Practice Address - Phone:706-234-0094
Practice Address - Fax:877-761-3771
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA041749207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA19089102AMedicaid
GA19089102AMedicaid
GA03BDBRQMedicare ID - Type Unspecified