Provider Demographics
NPI:1932292778
Name:ALEXANDER R SPARKUHL MD & RANJIT UROLOGY ASSOCIATES
Entity Type:Organization
Organization Name:ALEXANDER R SPARKUHL MD & RANJIT UROLOGY ASSOCIATES
Other - Org Name:UROLOGY ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:R
Authorized Official - Last Name:SPARKUHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-384-0500
Mailing Address - Street 1:700 SHADOW LN
Mailing Address - Street 2:430
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4126
Mailing Address - Country:US
Mailing Address - Phone:702-384-0500
Mailing Address - Fax:702-384-0093
Practice Address - Street 1:700 SHADOW LN
Practice Address - Street 2:430
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4126
Practice Address - Country:US
Practice Address - Phone:702-384-0500
Practice Address - Fax:702-384-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVQ07005455023890261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVWCHNLMedicare PIN