Organization
ANNA K. FARISS, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA K. FARISS MD (PRESIDENT)
(504) 650-7605
Entity
Organization
Contact information
Practice address
150 E PONCE DE LEON, AVENUE 120, DECATUR, GA 30030-2543
(504) 650-7605
Mailing address
150 E PONCE DE LEON, AVENUE 120, DECATUR, GA 30030-2543
(504) 650-7605
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
11309R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1670821
—
LA
Enumeration date
10/03/2006
Last updated
08/22/2020
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