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Organization

UROLOGICAL HEALTH CENTER, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MELVIN L FUSSELL M.D. (UROLOGIST)
(229) 271-4630
Entity
Organization

Contact information

Practice address
906 N 5TH ST, STE D, CORDELE, GA 31015-3200
(229) 271-4630
Mailing address
PO BOX 5098, CORDELE, GA 31010-5098
(229) 271-4630

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
162941944F
GA
05
162941944H
GA
Enumeration date
12/13/2006
Last updated
08/06/2012
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