Provider Demographics
NPI:1841387883
Name:THE UROLOGY CENTER OF SPARTANBURG INC
Entity Type:Organization
Organization Name:THE UROLOGY CENTER OF SPARTANBURG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:G
Authorized Official - Last Name:TWOMBLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-585-8221
Mailing Address - Street 1:391 SERPENTINE DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3096
Mailing Address - Country:US
Mailing Address - Phone:864-585-8221
Mailing Address - Fax:864-216-4290
Practice Address - Street 1:391 SERPENTINE DR
Practice Address - Street 2:SUITE 500
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3096
Practice Address - Country:US
Practice Address - Phone:864-585-8221
Practice Address - Fax:864-216-4290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2021-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty