Organization
GEORGIA UROLOGY PA
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
4450 CALIBRE XING NW, STE 1200, ACWORTH, GA 30101-4103
(770) 607-1893
(770) 607-2930
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040
(678) 284-4076
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11D2033897
CLIA
GA
Enumeration date
08/29/2011
Last updated
05/06/2026
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