Provider Demographics
NPI:1710287099
Name:UROLOGY TODAY, LLC
Entity Type:Organization
Organization Name:UROLOGY TODAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BRUMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:636-937-8883
Mailing Address - Street 1:1479 HWY 61
Mailing Address - Street 2:SUITE B
Mailing Address - City:CRYSTAL CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63019-0604
Mailing Address - Country:US
Mailing Address - Phone:636-937-8883
Mailing Address - Fax:
Practice Address - Street 1:1479 HWY 61
Practice Address - Street 2:SUITE B
Practice Address - City:CRYSTAL CITY
Practice Address - State:MO
Practice Address - Zip Code:63019-0604
Practice Address - Country:US
Practice Address - Phone:636-937-8883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty