Organization
NORTH FAYETTE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELVIN D WHITE MD (OWNER)
(770) 716-8228
Entity
Organization
Contact information
Practice address
290 HIGHWAY 314 STE B, FAYETTEVILLE, GA 30214-7813
(770) 716-8228
Mailing address
290 HIGHWAY 314 STE B, FAYETTEVILLE, GA 30214-7813
(770) 716-8228
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
33753
GA
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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