| Jonathan Barak Fass, MD | |
|
1000 Cowles Clinic Way Ste 100, Greensboro, GA 30642-5285 | |
| (706) 543-5858 | |
| (706) 543-2050 |
| Full Name | Jonathan Barak Fass |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Location | 1000 Cowles Clinic Way Ste 100, Greensboro, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104821917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 046089 (Georgia) | Primary |
| Entity Name | Dermatology Affiliates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730244872 PECOS PAC ID: 5799763975 Enrollment ID: O20040713000970 |
| Entity Name | Georgia Skin Cancer & Aestheitic Dermatology, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205026168 PECOS PAC ID: 0244328649 Enrollment ID: O20071119000529 |
| Entity Name | Dermatology Of Athens, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023115482 PECOS PAC ID: 0547385486 Enrollment ID: O20100915000459 |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Barak Fass, MD 1180 Resurgence Dr Ste 100, Watkinsville, GA 30677-7211 Ph: (706) 543-5858 | Jonathan Barak Fass, MD 1000 Cowles Clinic Way Ste 100, Greensboro, GA 30642-5285 Ph: (706) 543-5858 |
Dr. Jill Buckthal-mccuin, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1000 Cowles Clinc Way, Aspen Cottages, Greensboro, GA 30642 Phone: 706-225-7177 |