Individual
JULIAN J. NUSSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2020
(706) 721-1156
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2650
(706) 828-6410
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
018936
GA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
18936
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000891426A
—
GA
05
—
G18936
—
SC
Enumeration date
09/22/2006
Last updated
02/15/2018
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