Organization
GEORGIA UROLOGY FAYETTE ASC
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) 205-8360
Entity
Organization
Contact information
Practice address
1336 HWY 54W, BLDG 100, SUITE 101, FAYETTEVILLE, GA 30214
(770) 460-9777
(770) 460-0650
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040
(678) 284-4076
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/07/2009
Last updated
05/05/2026
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