Individual
DR. JUSTIN LEE FUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4401 RIVERCHASE DR, PHENIX CITY, AL 36867-7483
(334) 732-3526
(334) 732-3535
Mailing address
5942 BROOKSTONE BLVD, COLUMBUS, GA 31904-2908
(912) 381-2894
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17904
AL
183500000X
Pharmacist
RPH24247
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17904
PHARMACY
AL
Enumeration date
12/14/2020
Last updated
12/14/2020
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