Individual
DR. JANET TIRRELL FASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
105 CARRIAGE OAKS DR, TYRONE, GA 30290-1686
(770) 486-8206
(770) 486-8105
Mailing address
PO BOX 1085, TYRONE, GA 30290-1085
(770) 486-8206
(770) 486-8105
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
048773
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000963784
—
GA
01
—
048773
LICENSE
GA
Enumeration date
07/21/2005
Last updated
03/17/2018
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