Provider Demographics
NPI:1306211370
Name:UROLOGY CENTER-USA INC
Entity Type:Organization
Organization Name:UROLOGY CENTER-USA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES./CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-742-7757
Mailing Address - Street 1:1830 TOWN CENTER DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3292
Mailing Address - Country:US
Mailing Address - Phone:703-742-7757
Mailing Address - Fax:703-742-6857
Practice Address - Street 1:1830 TOWN CENTER DR
Practice Address - Street 2:SUITE 301
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3292
Practice Address - Country:US
Practice Address - Phone:703-742-7757
Practice Address - Fax:703-742-6857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040651174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010272840Medicaid
VA010272840Medicaid