Provider Demographics
NPI:1346229192
Name:UROLOGICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:UROLOGICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ROHLF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:563-359-1641
Mailing Address - Street 1:3319 SPRING ST STE 202
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2125
Mailing Address - Country:US
Mailing Address - Phone:563-359-1641
Mailing Address - Fax:563-359-4634
Practice Address - Street 1:3319 SPRING ST STE 202
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2125
Practice Address - Country:US
Practice Address - Phone:563-359-1641
Practice Address - Fax:563-359-4634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA07364OtherBLUE CROSS BLUE SHIELD
IL91338OtherBLUE CROSS BLUE SHIELD
IA0904060Medicaid
IA0073643Medicaid
IL91338OtherBLUE CROSS BLUE SHIELD
IA0904060Medicaid
IACP7499Medicare PIN
IA0184500001Medicare NSC
IL91338OtherBLUE CROSS BLUE SHIELD
ILCH6425Medicare PIN
IA=========OtherTAX ID NUMBER