Provider Demographics
NPI:1932289568
Name:UROLOGY OF INDIANA, L.L.C.
Entity Type:Organization
Organization Name:UROLOGY OF INDIANA, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:S
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-890-2000
Mailing Address - Street 1:679 E COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1049
Mailing Address - Country:US
Mailing Address - Phone:317-885-1250
Mailing Address - Fax:317-859-4268
Practice Address - Street 1:14300 E 138TH
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-0050
Practice Address - Country:US
Practice Address - Phone:317-813-1660
Practice Address - Fax:317-813-1667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2023-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1932289568OtherNCPDP
IN200288740BMedicaid
IN1487680518OtherGROUP NPI
IN1487680518OtherGROUP NPI
IN1932289568OtherNCPDP