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Individual

ALICE F. FAZEKAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3903 S COBB DR SE, SUITE 200, SMYRNA, GA 30080-8504
(770) 801-4646
(770) 801-5280
Mailing address
3903 S COBB DR SE, SUITE 200, SMYRNA, GA 30080-8504
(770) 801-4646
(770) 801-5280

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004858
GA

Other

Enumeration date
10/12/2006
Last updated
06/11/2010
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