Board Of Commissioners Of Fayette County

Specialty details in registry · Fayetteville, GA

Call (770) 305-5414 Directions

At a glance

140 Stonewall Ave W, Fayetteville, GA 30214-1520

NPPES record updated Oct 29, 2021. Public records can lag behind changes at a practice.

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  • Are you accepting new patients?
  • Do you accept my specific insurance plan?
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Insurance participation and appointment availability are not established by these public records.

Practice location

140 Stonewall Ave W
Fayetteville, GA 30214-1520
Professional details: NPI, taxonomy & registry record
NPI1790880474
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
3416L0300X
Enumeration date
Sep 14, 2006
Record updated
Oct 29, 2021
More registry details
Provider type
Organization · Type 2
Other reported name
<UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

3416L0300X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

140 Stonewall Ave W
Fayetteville, GA 30214-1520
Phone
(770) 305-5414
Fax
(770) 305-5190
Mailing address
PO BOX 9150

PADUCAH, KY 420029150
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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