Individual
MR. CHARLES MARCUS BASS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1485 JESSE JEWELL PKWY NE STE 220A, GAINESVILLE, GA 30501
(770) 740-1860
(678) 347-2104
Mailing address
925 N POINT PKWY STE 130, ALPHARETTA, GA 30005-5211
(770) 740-1860
(678) 347-2104
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006476
GA
Other
Enumeration date
06/28/2012
Last updated
09/20/2018
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