Organization
NORTH FAYETTE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE JONES-MARTIN (PRACTICE ADMINISTRATOR)
(803) 807-9533
Entity
Organization
Contact information
Practice address
101 DEVANT ST, SUITE 902, FAYETTEVILLE, GA 30214-2710
(770) 716-8228
(770) 716-6588
Mailing address
101 DEVANT ST, SUITE 902, FAYETTEVILLE, GA 30214-2710
(770) 716-8228
(770) 716-6588
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33753
GA
Other
Enumeration date
02/01/2012
Last updated
11/05/2012
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