Provider Demographics
NPI:1508889957
Name:UNIVERISTY UROLOGY, PLLC
Entity Type:Organization
Organization Name:UNIVERISTY UROLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CASALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-629-4220
Mailing Address - Street 1:234 E GRAY ST
Mailing Address - Street 2:SUITE 662
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1900
Mailing Address - Country:US
Mailing Address - Phone:502-629-4220
Mailing Address - Fax:502-629-4223
Practice Address - Street 1:234 E GRAY ST
Practice Address - Street 2:SUITE 662
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1900
Practice Address - Country:US
Practice Address - Phone:502-629-4220
Practice Address - Fax:502-629-4223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19584208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty