Provider Demographics
NPI:1316004716
Name:SCHUESSLER POPE KEHL BARNES & DURSO
Entity Type:Organization
Organization Name:SCHUESSLER POPE KEHL BARNES & DURSO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-747-2361
Mailing Address - Street 1:1062 FORSYTH ST STE 3B
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-8640
Mailing Address - Country:US
Mailing Address - Phone:478-743-3454
Mailing Address - Fax:
Practice Address - Street 1:1062 FORSYTH ST
Practice Address - Street 2:SUITE 3-B
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8637
Practice Address - Country:US
Practice Address - Phone:478-743-3454
Practice Address - Fax:478-743-6816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACB5605OtherRAIL ROAD MEDICARE GRP #
GA300021733EMedicaid
GA11D0717779OtherCLIA WAIVER
GA11D0717779OtherCLIA WAIVER