Provider Demographics
NPI:1952640583
Name:UROLOGY INSTITUTE, PC
Entity Type:Organization
Organization Name:UROLOGY INSTITUTE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:TRABUCCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-768-6800
Mailing Address - Street 1:5300 S HIGHWAY 95
Mailing Address - Street 2:SUITE K
Mailing Address - City:FORT MOHAVE
Mailing Address - State:AZ
Mailing Address - Zip Code:86426-9251
Mailing Address - Country:US
Mailing Address - Phone:928-768-6800
Mailing Address - Fax:928-768-6882
Practice Address - Street 1:5300 S HIGHWAY 95
Practice Address - Street 2:SUITE K
Practice Address - City:FORT MOHAVE
Practice Address - State:AZ
Practice Address - Zip Code:86426-9251
Practice Address - Country:US
Practice Address - Phone:928-768-6800
Practice Address - Fax:928-768-6882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ42374208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty