MEDICARE: DR. FORT FRASER FELKER JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	6898	GA

General Provider Information

NPI Number	:	1083812432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FORT FRASER FELKER JR. M.D.

Provider Business Mailing Address
First Line	:	3530 PIEDMONT ROAD N.E.
Second Line	:	SUITE 12K
City	:	ATLANTA
State	:	GA
Zip	:	30305-1551
Country	:	US
Telephone Number	:	404-814-9242
Fax Number	:

Provider Business Practice Location Address
First Line	:	3530 PIEDMONT RD N.E.
Second Line	:	SUITE 12K
City	:	ATLANTA
State	:	GA
Zip	:	30305-1551
Country	:	US
Telephone Number	:	404-814-9242
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2007
Last Update Date	:	07/08/2007

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