# HAZIM A. FARISI MD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Friendship Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801078001
- **Authorized official:** MARY FARISI (OFFICE MANAGER)
- **Authorized official phone:** (678) 714-5692

## Contact information

- **Practice address:** 4965 FRIENDSHIP RD, SUITE 103, BUFORD, GA 30518-1700
- **Practice address phone:** (678) 714-5692
- **Practice address fax:** (678) 714-5693
- **Mailing address:** 4965 FRIENDSHIP RD, SUITE 103, BUFORD, GA 30518-1700
- **Mailing address phone:** (678) 714-5692
- **Mailing address fax:** (678) 714-5693

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 016201 | GA | Yes |

## Other

- **Enumeration date:** 11/29/2007
- **Last updated:** 08/17/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00457168C | — | GA |
| 01 | — | 1700938123 | INDIVIDUAL NPI | GA |
| 01 | — | 1801078001 | GROUP NPI | GA |
| 01 | — | GRP4668 | GROUP PIN | GA |