Individual
JONATHAN BARAK FASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 COWLES CLINIC WAY STE 100, GREENSBORO, GA 30642-5285
(706) 543-5858
(706) 543-2050
Mailing address
1180 RESURGENCE DR STE 100, WATKINSVILLE, GA 30677-7211
(706) 543-5858
(706) 543-2050
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
046089
GA
Other
Enumeration date
06/17/2005
Last updated
01/25/2024
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