Provider Demographics
NPI:1346422995
Name:NORTH GEORGIA UROLOGY GROUP, P.C.
Entity Type:Organization
Organization Name:NORTH GEORGIA UROLOGY GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-625-3822
Mailing Address - Street 1:PO BOX 879
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30703-0879
Mailing Address - Country:US
Mailing Address - Phone:706-625-3822
Mailing Address - Fax:706-625-8030
Practice Address - Street 1:101 PROFESSIONAL CT SE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-7036
Practice Address - Country:US
Practice Address - Phone:706-625-3822
Practice Address - Fax:706-625-8030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0303702088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric UrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
34BDDHPMedicare PIN
D50429Medicare UPIN