Provider Demographics
NPI:1619013877
Name:KNOX UROLOGY INC
Entity Type:Organization
Organization Name:KNOX UROLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMANADHARAO
Authorized Official - Middle Name:
Authorized Official - Last Name:PAMULAPATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-397-7220
Mailing Address - Street 1:812 COSHOCTON AVE
Mailing Address - Street 2:
Mailing Address - City:MT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-1947
Mailing Address - Country:US
Mailing Address - Phone:740-397-7220
Mailing Address - Fax:740-397-0682
Practice Address - Street 1:812 COSHOCTON AVE
Practice Address - Street 2:
Practice Address - City:MT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-1947
Practice Address - Country:US
Practice Address - Phone:740-397-7220
Practice Address - Fax:740-397-0682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35042634208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0370325Medicaid
OH0449982OtherMEDICARE
OH0449981OtherMEDICARE
A77677Medicare UPIN
OH0449981OtherMEDICARE