Provider Demographics
NPI:1891849691
Name:MUELLER, TERRY LEE (DO)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:LEE
Last Name:MUELLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W HOSPITAL RD
Mailing Address - Street 2:ORTHOPAEDIC SURGERY CLINIC
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5741
Mailing Address - Country:US
Mailing Address - Phone:706-787-2741
Mailing Address - Fax:706-787-2565
Practice Address - Street 1:300 W HOSPITAL RD
Practice Address - Street 2:ORTHOPAEDIC SURGERY CLINIC
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905-5741
Practice Address - Country:US
Practice Address - Phone:706-787-2741
Practice Address - Fax:706-787-2565
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002729A171000000X
GA060223207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No171000000XOther Service ProvidersMilitary Health Care Provider