Organization
ROGER W HUELSNITZ MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARLEEN C WILSON (OFFICE MANAGER)
(912) 487-1737
Entity
Organization
Contact information
Practice address
80 HUXFORD ST, HOMERVILLE, GA 31634-2356
(912) 487-1737
(912) 487-1739
Mailing address
80 HUXFORD ST, HOMERVILLE, GA 31634-2356
(912) 487-1737
(912) 487-1739
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
030103
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000355264F
—
GA
Enumeration date
12/01/2008
Last updated
12/01/2008
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