North Fayette Family Practice

NPI 1053683359 - Family Medicine - 207Q00000X

NPI Details
NPI 1053683359
Enumeration Date 02/01/2012
Last Updated 11/05/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name MICHELLE MICHELLE
Position PRACTICE ADMINISTRATOR
Phone (770) 716-8228
Fax (770) 716-6588
Practice Location
101 DEVANT ST
SUITE 902
FAYETTEVILLE GA, 30214-2710, US
Phone (770) 716-8228
Fax (770) 716-6588
Business Location
101 DEVANT ST
SUITE 902
FAYETTEVILLE GA, 30214-2710, US
Phone (770) 716-8228
Fax (770) 716-6588
Toxanomy
Taxonomy Code 207Q00000X
License State Georgia
License Number 33753
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According to our database, North Fayette Family Practice NPI is 1053683359, taxonomy code is 207Q00000X and license number is 33753, license state is located at Georgia. North Fayette Family Practice physically located at 101 Devant St, Fayetteville GA, 30214-2710. NPI Number 1033115704 has the healthcare provider type.

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1053683359 NPI number is provided on an as is basis without warranty of any kind. 1053683359 is maintained by the National Plan & Provider Enumeration System. The contents of North Fayette Family Practice are for informational purposes only.