Provider First Line Business Practice Location Address:
200 INDUSTRIAL BLVD.
Provider Second Line Business Practice Location Address:
HOSPITALISTS AT FAIRVIEW PARK LLC
Provider Business Practice Location Address City Name:
DUBLIN
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-274-3925
Provider Business Practice Location Address Fax Number:
478-274-3663
Provider Enumeration Date:
11/17/2006