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Individual

R MARK HAZEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1315 JESSE JEWELL PKWY NE STE 300, GAINESVILLE, GA 30501
(770) 848-6190
Mailing address
10600 MEDLOCK BRIDGE RD, DULUTH, GA 30097-8404

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
073631
GA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD47860
TN

Other

Enumeration date
08/03/2006
Last updated
01/14/2023
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