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1245394873
JERRY JOSEPH FASOLDT
FORT STEWART, GA
NPI
1245394873
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IN 01064093A)
Enumeration Date
2006-12-20
Last Update Date
2017-03-03
Business Address
Dr. JERRY JOSEPH FASOLDT M.D.
1061 HARMON AVE
FORT STEWART, GA 31314-5641
Phone number: 912-435-6965
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Mailing Address
Dr. JERRY JOSEPH FASOLDT M.D.
1061 HARMON AVE
FORT STEWART, GA 31314-5641
Phone number: 912-435-6965
Copy
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