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Organization

UROLOGICAL HEALTH CENTER, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ANGELA YVETTE FUSSELL (OFFICE MANAGER)
(478) 333-6961
Entity
Organization

Contact information

Practice address
1770 WATSON BOULEVARD, WARNER ROBINS, GA 31093
(478) 333-6961
(478) 333-6964
Mailing address
1770 WATSON BOULEVARD, WARNER ROBINS, GA 31093
(478) 333-6961
(478) 333-6964

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
052565
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
162941944H
GA
Enumeration date
08/21/2018
Last updated
08/21/2018
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