Individual
JOSE LUIS FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2201 TALMADGE RD, HAMPTON, GA 30228-1608
(678) 479-1234
(678) 479-5678
Mailing address
530 CITY PARK DR, MCDONOUGH, GA 30252-1021
(770) 317-6312
(770) 506-4368
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
038483
GA
Other
Enumeration date
10/03/2005
Last updated
08/28/2007
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