Provider Demographics
NPI:1255764007
Name:WETUMPKA UROLOGY LLC
Entity type:Organization
Organization Name:WETUMPKA UROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:J
Authorized Official - Last Name:VEREB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-386-9357
Mailing Address - Street 1:525 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-1626
Mailing Address - Country:US
Mailing Address - Phone:334-386-9357
Mailing Address - Fax:334-532-0137
Practice Address - Street 1:2257 TAYLOR RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7790
Practice Address - Country:US
Practice Address - Phone:334-386-9357
Practice Address - Fax:334-532-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty