# KOKOMO UROLOGY INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104026160
- **Authorized official:** DR. WILLIS W PEELLE M.D. (PRESIDENT)
- **Authorized official phone:** (765) 455-4075

## Contact information

- **Practice address:** 2345 W LINCOLN RD, KOKOMO, IN 46902-8012
- **Practice address phone:** (765) 455-4075
- **Practice address fax:** (765) 455-4094
- **Mailing address:** 2345 W LINCOLN RD, KOKOMO, IN 46902-8012
- **Mailing address phone:** (765) 455-4075
- **Mailing address fax:** (765) 455-4094

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | IN | Yes |

## Other

- **Enumeration date:** 07/18/2007
- **Last updated:** 05/12/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100136840A | — | IN |