Provider Demographics
NPI:1164537015
Name:VALLEY UROLOGICAL ASSOCIATES INC.
Entity Type:Organization
Organization Name:VALLEY UROLOGICAL ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:DOEBLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-741-8025
Mailing Address - Street 1:701 BROAD ST
Mailing Address - Street 2:SUITE B 4TH FL
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1652
Mailing Address - Country:US
Mailing Address - Phone:412-741-8025
Mailing Address - Fax:
Practice Address - Street 1:701 BROAD ST
Practice Address - Street 2:SUITE B 4TH FL
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1652
Practice Address - Country:US
Practice Address - Phone:412-741-8025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001048036Medicaid
PA001048036Medicaid