Provider Demographics
NPI:1457384489
Name:THE UROLOGY GROUP, PLLC
Entity Type:Organization
Organization Name:THE UROLOGY GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:G
Authorized Official - Last Name:HAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-235-8008
Mailing Address - Street 1:1211 N SHARTEL AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-2425
Mailing Address - Country:US
Mailing Address - Phone:405-235-8008
Mailing Address - Fax:405-235-0902
Practice Address - Street 1:1211 N SHARTEL AVE STE 300
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-2425
Practice Address - Country:US
Practice Address - Phone:405-235-8008
Practice Address - Fax:405-235-0902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========OtherFEDERAL TAX IDENTIFICATIO