Organization
DAHLONEGA UROLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIO MANUEL OSSORIO M.D. (UROLOGIST)
(518) 497-6898
Entity
Organization
Contact information
Practice address
39 WILD RIDGE LN, DAHLONEGA, GA 30533-9109
(518) 497-6898
(518) 497-6903
Mailing address
PO BOX 382, DAHLONEGA, GA 30533-0007
(518) 497-6898
(518) 497-6903
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
054175
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054175
GEORGIA MEDICAL LICENSE
GA
01
—
1942315635
NPI NUMBER
GA
05
—
824346200A
—
GA
Enumeration date
09/21/2006
Last updated
02/14/2009
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