Provider Demographics
NPI:1669555496
Name:UROLOGY SPECIALISTS LTD
Entity type:Organization
Organization Name:UROLOGY SPECIALISTS LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:A
Authorized Official - Last Name:HURM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-944-9679
Mailing Address - Street 1:9327 N 3RD STREET
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020
Mailing Address - Country:US
Mailing Address - Phone:602-944-9679
Mailing Address - Fax:602-944-8471
Practice Address - Street 1:9327 N 3RD STREET
Practice Address - Street 2:SUITE 204
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020
Practice Address - Country:US
Practice Address - Phone:602-944-9679
Practice Address - Fax:602-944-8471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0292130001332B00000X
AZ7498208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0292130001Medicare NSC
AZZWCLGSMedicare PIN
AZC99674Medicare UPIN