Provider Demographics
NPI:1093069452
Name:UROLOGY SPECIALISTS SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:UROLOGY SPECIALISTS SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:M
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:478-745-6576
Mailing Address - Street 1:5400 BOWMAN RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-8879
Mailing Address - Country:US
Mailing Address - Phone:478-745-6576
Mailing Address - Fax:478-746-0018
Practice Address - Street 1:5400 BOWMAN RD
Practice Address - Street 2:SUITE 102
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-8879
Practice Address - Country:US
Practice Address - Phone:478-745-6576
Practice Address - Fax:478-746-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical