Individual
DR. TAYYAB FAYYAZ BHUTTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1850 N COLUMBIA ST, SUITE 3, MILLEDGEVILLE, GA 31061-2385
(478) 453-4101
(478) 453-4105
Mailing address
311 WIMBLEDON COURT, MACON, GA 31211
(478) 742-7949
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
048335
GA
208M00000X
Hospitalist Physician
048335
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00850957A
—
GA
Enumeration date
09/27/2006
Last updated
11/04/2013
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