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Contact Information

GLENN E. FUSSELL
2827 WARM SPRINGS RD
SUITE 3B
COLUMBUS, GA31904-5246
 Phone: 706-324-4177
 Fax: 706-322-9637
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for GLENN E. FUSSELL

NPI Number 1770766909
LBN Legal business name GLENN E. FUSSELL
Authorized official GLENN FUSSELL - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/11/2007
Last updated 03/31/2008 - About 18 years ago
Identifiers
GA License # 026777
GA Medicaid 00330063C
Other 08BDPHD MEDICARE PTAN
Other GRP4568 MEDICARE, PTAN
GA Other DG5108 RAILROAD MEDICARE GRP NUM
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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