Provider Demographics
NPI:1689864860
Name:UROLOGY SPECIALISTS OF COASTAL GEORGIA
Entity Type:Organization
Organization Name:UROLOGY SPECIALISTS OF COASTAL GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:SHOOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-354-5779
Mailing Address - Street 1:613 STEPHENSON AVE
Mailing Address - Street 2:STE #208
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405
Mailing Address - Country:US
Mailing Address - Phone:912-354-5779
Mailing Address - Fax:912-356-5421
Practice Address - Street 1:613 STEPHENSON AVE
Practice Address - Street 2:STE #208
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405
Practice Address - Country:US
Practice Address - Phone:912-354-5779
Practice Address - Fax:912-356-5421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty