Provider Demographics
NPI:1013197631
Name:TRUESDALE & MORROW UROLOGY
Entity Type:Organization
Organization Name:TRUESDALE & MORROW UROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-926-0507
Mailing Address - Street 1:200 CAUGHMAN FARM LN STE 100
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7342
Mailing Address - Country:US
Mailing Address - Phone:803-926-0507
Mailing Address - Fax:803-926-0536
Practice Address - Street 1:200 CAUGHMAN FARM LN STE 100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7342
Practice Address - Country:US
Practice Address - Phone:803-926-0507
Practice Address - Fax:803-926-0536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-12
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20513208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7154Medicare PIN