Provider Demographics
NPI:1538279187
Name:SCHUESSLER, CARL CLIFTON (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:CLIFTON
Last Name:SCHUESSLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1062 FORSYTH ST
Mailing Address - Street 2:STE 3B
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201
Mailing Address - Country:US
Mailing Address - Phone:478-743-3454
Mailing Address - Fax:478-743-6816
Practice Address - Street 1:1062 FORSYTH ST
Practice Address - Street 2:STE 3B
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201
Practice Address - Country:US
Practice Address - Phone:478-743-3454
Practice Address - Fax:478-743-6816
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA012560207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00418151AMedicaid
D30751Medicare UPIN