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DR. JANET TIRRELL FASON DO

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1588664429

Individual Registrant:
DR. JANET TIRRELL FASON DO
Gender: F
Not Sole Proprietor

Location and contact information for practice:
105 CARRIAGE OAKS DR  TYRONE, GA 30290-1686 US
Tel: 770-486-8206  Fax: 770-486-8105

Contact information for business:
PO BOX 1085  TYRONE, GA 30290-1085 US
Tel: 770-486-8206  Fax: 770-486-8105

Registration Information:
NPI: 1588664429
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
GA048773

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
000963784GA05
LICENSE048773GA01




HEALTH CARE JOBS GA - Page 1



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