Coosa Valley Urology, P.c.

NPI 1083831804 - Specialist - 174400000X

NPI Details
NPI 1083831804
Enumeration Date 04/20/2007
Last Updated 10/04/2013
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MAMOUN R MAMOUN
Position OWNER
Phone (256) 245-2269
Fax (256) 245-2260
Practice Location
16 SOUTH DOUGLAS AVENUE
SYLACAUGA AL, 35150, US
Phone (256) 245-2269
Fax (256) 245-2260
Business Location
16 SOUTH DOUGLAS AVENUE
SYLACAUGA AL, 35150, US
Phone (256) 245-2269
Fax (256) 245-2260
Toxanomy
Taxonomy Code 174400000X
License State Alabama
License Number 8767
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According to our database, Coosa Valley Urology, P.c. NPI is 1083831804, taxonomy code is 174400000X and license number is 8767, license state is located at Alabama. Coosa Valley Urology, P.c. physically located at 16 South Douglas Avenue, Sylacauga AL, 35150. NPI Number 1033115704 has the healthcare provider type.

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1083831804 NPI number is provided on an as is basis without warranty of any kind. 1083831804 is maintained by the National Plan & Provider Enumeration System. The contents of Coosa Valley Urology, P.c. are for informational purposes only.