# GEORGIA UROLOGY PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265995724
- **Authorized official:** DAN FELLNER (CEO)
- **Authorized official phone:** (678) 205-8360

## Contact information

- **Practice address:** 6000 HILLANDALE DR STE 110, LITHONIA, GA 30058-4858
- **Practice address phone:** (678) 205-8455
- **Practice address fax:** (678) 284-4078
- **Mailing address:** 1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
- **Mailing address phone:** (678) 284-4049
- **Mailing address fax:** (678) 284-4078

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 04/11/2019
- **Last updated:** 05/06/2026