Provider Demographics
NPI:1831717867
Name:UROLOGY ASSOCIATES OF EAST ALABAMA LLC
Entity type:Organization
Organization Name:UROLOGY ASSOCIATES OF EAST ALABAMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:334-528-1310
Mailing Address - Street 1:121 N 20TH ST STE 19
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5456
Mailing Address - Country:US
Mailing Address - Phone:334-749-8146
Mailing Address - Fax:334-749-8155
Practice Address - Street 1:121 N 20TH ST STE 19
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5456
Practice Address - Country:US
Practice Address - Phone:334-749-8146
Practice Address - Fax:334-749-8155
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST ALABAMA MEDICAL DEVELOPMENT ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty