| Fayette Family Medicine | |
|
101 Devant Street Suite 105 Fayetteville GA 30214-7636 | |
| (678) 519-3189 | |
| Not Available |
| Full Name | Fayette Family Medicine |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 101 Devant Street, Fayetteville, Georgia |
| Authorized Official Name and Position | Floyd Soriano (PRESIDENT AND CEO) |
| Authorized Official Contact | 6785193189 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fayette Family Medicine 101 Devant Street Suite 105 Fayetteville GA 30214-7636 Ph: (678) 519-3189 | Fayette Family Medicine 101 Devant Street Suite 105 Fayetteville GA 30214-7636 Ph: (678) 519-3189 |
| NPI Number | 1093020240 |
|---|---|
| Provider Enumeration Date | 08/12/2010 |
| Last Update Date | 10/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093020240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Georgia) | Primary |
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