Provider Demographics
NPI:1114943677
Name:UROLOGY SPECIALISTS PC
Entity Type:Organization
Organization Name:UROLOGY SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:ELLIOT
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-572-3737
Mailing Address - Street 1:6751 N 72ND ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-1746
Mailing Address - Country:US
Mailing Address - Phone:402-572-3737
Mailing Address - Fax:402-572-3415
Practice Address - Street 1:6751 N 72ND ST
Practice Address - Street 2:SUITE 210
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-1746
Practice Address - Country:US
Practice Address - Phone:402-572-3737
Practice Address - Fax:402-572-3415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========Medicaid
NE=========Medicaid
NECJ9058Medicare ID - Type UnspecifiedRAILROAD MEDICARE GRP #
IAI6278Medicare ID - Type UnspecifiedIOWA GROUP #
IACJ9059Medicare ID - Type UnspecifiedRAILROAD IOWA GRP #