Hazim A Farisi, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

016201 Issued in GA

Practice address

4965 Friendship Rd
St 103
Buford, GA 30518-1700

Phone

(678) 714-5692

Fax

(678) 714-5693

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1700938123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 FRIENDSHIP RD",
            "address_2": "ST 103",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305181700",
            "telephone_number": "678-714-5692",
            "fax_number": "678-714-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4965 FRIENDSHIP RD",
            "address_2": "ST 103",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305181700",
            "telephone_number": "678-714-5692",
            "fax_number": "678-714-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARISI",
        "first_name": "HAZIM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "016201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00457168C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Buford, GA
• Providers in Buford, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.