# FIRST UROLOGY, PSC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FIRST UROLOGY,PSC
- **Other names:** dba Southern Indiana RadiationTherapy Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1922099811
- **Legal business name:** FIRST UROLOGY,PSC
- **Authorized official:** MICHEAL SHANNON (CEO)
- **Authorized official phone:** (812) 282-3899

## Contact information

- **Practice address:** 101 HOSPITAL BLVD, JEFFERSONVILLE, IN 47130-3769
- **Practice address phone:** (812) 282-3899
- **Practice address fax:** (812) 282-4172
- **Mailing address:** 101 HOSPITAL BLVD, JEFFERSONVILLE, IN 47130-3769
- **Mailing address phone:** (812) 282-3899
- **Mailing address fax:** (812) 282-4172

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | — |
| 2085R0001X | Radiation Oncology Physician | — | NULL | — |
| 2085R0001X | Radiation Oncology Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LA2100X | Acute Care Nurse Practitioner | — | NULL | — |
| 363LA2100X | Acute Care Nurse Practitioner | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/31/2005
- **Last updated:** 07/01/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100075260 | — | IN |
| 05 | — | 65906414 | — | KY |
| 05 | — | 78902830 | — | KY |
| 01 | — | CF7705 | RR MEDICARE | KY |
| 01 | — | CG9483 | RR MEDCIARE | IN |