Organization
SOUTH GEORGIA UROLOGY GROUP, P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA J. GURLEY (OFFICE MANAGER)
(229) 228-5500
Entity
Organization
Contact information
Practice address
116 MIMOSA DR, SUITE 2, THOMASVILLE, GA 31792-6605
(229) 228-5500
(229) 226-5787
Mailing address
PO BOX 1679, P. O. BOX 1679, THOMASVILLE, GA 31799-1679
(229) 228-5500
(229) 226-5787
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300027790C
—
GA
05
—
300032989A
—
GA
Enumeration date
11/16/2006
Last updated
06/07/2013
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