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Individual

DR. FANTA ELIZABETH KASIAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
104 N BELAIR RD, SUITE 101, EVANS, GA 30809-6503
(706) 922-3669
Mailing address
104 N BELAIR RD, SUITE 101, EVANS, GA 30809-6503
(706) 922-3669

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4212
GA

Other

Enumeration date
06/24/2010
Last updated
10/03/2014
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