# UROLOGY ASSOCIATES MEDICAL GROUP, PC

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

## Provider details

- **NPI number:** 1902982051
- **Authorized official:** PHILLIP LOWE MD (PRESIDENT)
- **Authorized official phone:** (307) 733-7460

## Contact information

- **Practice address:** 555 EAST BROADWAY, SUITE 207, JACKSON, WY 83001-9998
- **Practice address phone:** (307) 733-7460
- **Practice address fax:** (307) 733-7482
- **Mailing address:** PO BOX 12890, JACKSON, WY 83002-2890
- **Mailing address phone:** (307) 733-7460
- **Mailing address fax:** (307) 733-7482

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 6215A | WY | Yes |
| 2088P0231X | Pediatric Urology Physician | 6215A | WY | — |

## Other

- **Enumeration date:** 10/31/2006
- **Last updated:** 08/26/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 114954700 | — | WY |
| 05 | — | 118827500 | — | WY |
| 05 | — | 806233600 | — | ID |
| 05 | — | 806684400 | — | ID |