| Glenn E. Fussell | |
|
2827 Warm Springs Rd Suite 3b Columbus GA 31904-5246 | |
| (706) 324-4177 | |
| (706) 322-9637 |
| Full Name | Glenn E. Fussell |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 2827 Warm Springs Rd, Columbus, Georgia |
| Authorized Official Name and Position | Glenn E. Fussell (OWNER) |
| Authorized Official Contact | 7063244177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenn E. Fussell 2827 Warm Springs Rd Suite 3b Columbus GA 31904-5246 Ph: (706) 324-4177 | Glenn E. Fussell 2827 Warm Springs Rd Suite 3b Columbus GA 31904-5246 Ph: (706) 324-4177 |
| NPI Number | 1770766909 |
|---|---|
| Provider Enumeration Date | 12/11/2007 |
| Last Update Date | 03/31/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770766909 | NPI | - | NPPES |
| 08BDPHD | Other | MEDICARE PTAN | |
| GRP4568 | Other | MEDICARE, PTAN | |
| DG5108 | Other | GA | RAILROAD MEDICARE GRP NUM |
| 00330063C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | 026777 (Georgia) | Primary |
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