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Organization

GEORGIA UROLOGY NORTHEAST LLC

Active
Parent organization
GEORGIA UROLOGY, PA
Organization subpart
Yes

Provider details

NPI number
Legal business name
GEORGIA UROLOGY, PA
Authorized official
DAN FELLNER (CEO)
(678) 284-4040
Entity
Organization

Contact information

Practice address
1223 FRIENDSHIP RD., BLDG. 400, SUITE 100, BRASELTON, GA 30517
(678) 205-8387
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Enumeration date
12/17/2024
Last updated
05/06/2026
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