Provider Demographics
NPI:1992868251
Name:COMMONWEALTH UROLOGY, PSC
Entity Type:Organization
Organization Name:COMMONWEALTH UROLOGY, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:GEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-277-5766
Mailing Address - Street 1:1760 NICHOLASVILLE RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1471
Mailing Address - Country:US
Mailing Address - Phone:859-277-5766
Mailing Address - Fax:859-277-3406
Practice Address - Street 1:511 MIDDLEBURG ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:42539
Practice Address - Country:US
Practice Address - Phone:859-236-9670
Practice Address - Fax:859-236-7656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6469Medicare PIN