# UNIVERSITY UROLOGISTS, INC., PC

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

## Provider details

- **NPI number:** 1104877141
- **Authorized official:** DR. MICHAEL O KOCH MD (PRESIDENT)
- **Authorized official phone:** (317) 944-7338

## Contact information

- **Practice address:** 535 BARNHILL DR STE 420, INDIANAPOLIS, IN 46202-5116
- **Practice address phone:** (317) 278-1979
- **Practice address fax:** (317) 278-1981
- **Mailing address:** 250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
- **Mailing address phone:** (888) 484-3258

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 01048495A | IN | Yes |
| 2088P0231X | Pediatric Urology Physician | 01048495A | IN | — |
| 363LP0200X | Pediatric Nurse Practitioner | 71001248A | IN | — |

## Other

- **Enumeration date:** 05/15/2006
- **Last updated:** 01/19/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100057570 | — | IN |