Fussell, Fred W
Fussell, Fred W is an sole proprietor health care provider with primary practice located at 210 Washington St Nw Ste. 200, Gainesville GA 30501-3672. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Fussell, Fred W can be contacted via phone (770) 536-3902.Contact Information
Primary practice address
210 Washington St Nw Ste. 200
Gainesville GA 30501-3672
Phone: (770) 536-3902
Fax: (770) 536-3902
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1302 | Georgia |
Profile Details
| NPI number | 1184654170 |
|---|---|
| LBN Legal business name | Fussell, Fred W |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 4th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184654170 | NPPES |
| Georgia | MEDICAID | 00378111A |
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