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Individual

MR. HORACE MICHAEL DELISSER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
426 EXCHANGE BLVD STE 600, BETHLEHEM, GA 30620-1794
(770) 848-6190
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
11352
GA
363AS0400X
Surgical Physician Assistant
25MP00494800
NJ
363AS0400X
Surgical Physician Assistant
MA059415
PA
363AS0400X
Surgical Physician Assistant

Other

Enumeration date
10/18/2017
Last updated
01/16/2023
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