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Individual

BETTY JO LYNN FANCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3711 EISENHOWER PKWY, MACON, GA 31206-3672
(478) 633-1000
Mailing address
3711 EISENHOWER PKWY, MACON, GA 31206-3672
(478) 633-8730

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
02261
GA

Other

Enumeration date
03/09/2007
Last updated
09/24/2020
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