Organization
FAYETTE SURGICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA LOWERY (OFFICE MANAGER)
(770) 719-5660
Entity
Organization
Contact information
Practice address
1265 HIGHWAY 54 W STE 500B, FAYETTEVILLE, GA 30214-4556
(770) 719-5660
Mailing address
1265 HIGHWAY 54 W STE 500B, FAYETTEVILLE, GA 30214-4556
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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