Provider Demographics
NPI:1760453674
Name:ASSOCIATED UROLOGISTS, PA
Entity Type:Organization
Organization Name:ASSOCIATED UROLOGISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:DEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-537-8710
Mailing Address - Street 1:1133 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2770
Mailing Address - Country:US
Mailing Address - Phone:785-537-8710
Mailing Address - Fax:785-537-0562
Practice Address - Street 1:1133 COLLEGE AVE
Practice Address - Street 2:BLDG G SUITE 100
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2756
Practice Address - Country:US
Practice Address - Phone:785-537-8710
Practice Address - Fax:785-537-0562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS016261Medicare PIN