Provider Demographics
NPI:1386826741
Name:UROLOGY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:UROLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-289-7444
Mailing Address - Street 1:2525 W UNIVERSITY AVE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-3421
Mailing Address - Country:US
Mailing Address - Phone:765-289-7444
Mailing Address - Fax:765-289-8628
Practice Address - Street 1:141 W 22ND ST
Practice Address - Street 2:SUTIE 213
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-4304
Practice Address - Country:US
Practice Address - Phone:765-643-0766
Practice Address - Fax:765-640-2353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01037193A208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INF78622Medicare UPIN
INQ25919Medicare UPIN
INI11570Medicare UPIN
INC02618Medicare UPIN
INA99214Medicare UPIN