Basic Information
| Provider Information | |||||||||
| NPI: | 1306952171 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UROLOGY ASSOCIATES OF COLUMBUS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1538 13TH AVENUE | ||||||||
| Address2: | BUILDING A | ||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063234000 | ||||||||
| FaxNumber: | 7063234848 | ||||||||
| Practice Location | |||||||||
| Address1: | 1538 13TH AVENUE | ||||||||
| Address2: | BUILDING A | ||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063234000 | ||||||||
| FaxNumber: | 7063234848 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2006 | ||||||||
| LastUpdateDate: | 02/25/2010 | ||||||||
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| AuthorizedOfficialLastName: | JARRELL | ||||||||
| AuthorizedOfficialFirstName: | TODD | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7063234000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
No ID Information.