Organization
UROLOGICAL SURGICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELVIN LEE CHRISTOPHER FUSSELL M.D. (OWNER/BOARD CERTIFIED UROLOGIST)
(478) 333-6961
Entity
Organization
Contact information
Practice address
102 HICKORY ST, WARNER ROBINS, GA 31093-3047
(478) 333-6961
Mailing address
PO BOX 5098, CORDELE, GA 31010-5098
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
052565
GA
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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