Provider Demographics
NPI:1598954331
Name:AUSABLE UROLOGY, P.C.
Entity Type:Organization
Organization Name:AUSABLE UROLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:STIRLING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:989-348-6610
Mailing Address - Street 1:809 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-1417
Mailing Address - Country:US
Mailing Address - Phone:989-348-6610
Mailing Address - Fax:989-348-2723
Practice Address - Street 1:809 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-1417
Practice Address - Country:US
Practice Address - Phone:989-348-6610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4393470Medicaid
MI4393470Medicaid