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JAIME ANDRES DAZA FAWCETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 SIVLEY RD SW, HUNTSVILLE, AL 35801-4421
(256) 265-3880
(256) 265-3886
Mailing address
PO BOX 21007, HUNTSVILLE, AL 35813-5007
(256) 265-3880
(256) 265-3886

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
31090
AL
208M00000X
Hospitalist Physician
Primary
MD.31090
AL

Other

Enumeration date
08/20/2008
Last updated
07/26/2024
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