Provider Demographics
NPI:1992721922
Name:SONS, MARTY A (CSA)
Entity type:Individual
Prefix:
First Name:MARTY
Middle Name:A
Last Name:SONS
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2301
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-0006
Mailing Address - Country:US
Mailing Address - Phone:678-229-1552
Mailing Address - Fax:770-926-7519
Practice Address - Street 1:1103 PEAKS WAY
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-1993
Practice Address - Country:US
Practice Address - Phone:678-229-1552
Practice Address - Fax:770-926-7519
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2616246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant