Georgia Urology Pa

NPI 1053536243 - Urology - 208800000X

NPI Details
NPI 1053536243
Enumeration Date 04/15/2007
Last Updated 01/28/2015
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MARK A MARK
Position MANAGING PARTNER
Phone (770) 963-2451
Fax (770) 962-0017
Practice Location
500 MEDICAL CENTER BLVD
SUITE 220
LAWRENCEVILLE GA, 30046, US
Phone (770) 963-2451
Fax (770) 962-0017
Business Location
1930 BRANNAN RD
MCDONOUGH GA, 30253-4310, US
Phone (678) 284-4040
Fax (678) 284-4076
Toxanomy
Taxonomy Code 208800000X
License State
License Number
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According to our database, Georgia Urology Pa NPI is 1053536243, taxonomy code is 208800000X Georgia Urology Pa physically located at 500 Medical Center Blvd, Lawrenceville GA, 30046. NPI Number 1033115704 has the healthcare provider type.

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1053536243 NPI number is provided on an as is basis without warranty of any kind. 1053536243 is maintained by the National Plan & Provider Enumeration System. The contents of Georgia Urology Pa are for informational purposes only.