Provider Demographics
NPI:1770390270
Name:UROLOGY SPECIALISTS, PC
Entity type:Organization
Organization Name:UROLOGY SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:JIMINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-882-3603
Mailing Address - Street 1:4704 WHITESBURG DR SE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-1680
Mailing Address - Country:US
Mailing Address - Phone:256-882-3603
Mailing Address - Fax:
Practice Address - Street 1:4704 WHITESBURG DR SE SUITE 100
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-1680
Practice Address - Country:US
Practice Address - Phone:256-882-3603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UROLOGY SPECIALISTS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site