Provider Demographics
NPI:1356700298
Name:UROGYNECOLOGY CENTER OF HUNTSVILLE, P.C.
Entity type:Organization
Organization Name:UROGYNECOLOGY CENTER OF HUNTSVILLE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KUBIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-694-7966
Mailing Address - Street 1:204 LOWE AVE SE
Mailing Address - Street 2:BUILDING 1, SUITE 2
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4262
Mailing Address - Country:US
Mailing Address - Phone:256-517-8861
Mailing Address - Fax:256-517-8872
Practice Address - Street 1:204 LOWE AVE SE
Practice Address - Street 2:BUILDING 1, SUITE 2
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4262
Practice Address - Country:US
Practice Address - Phone:256-517-8861
Practice Address - Fax:256-517-8872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-21
Last Update Date:2016-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29160207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1508848540OtherINDIVIDUAL NPI
AL1508848540OtherINDIVIDUAL NPI