Organization
TRI-COUNTY UROLOGY INC
Active
Organization
TRI-COUNTY UROLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD H RUDICK MD (PRESIDENT)
(814) 781-8669
Entity
Organization
Contact information
Practice address
761 JOHNSONBURG RD, SUITE 350, SAINT MARYS, PA 15857-3483
(814) 781-8669
(814) 781-8671
Mailing address
761 JOHNSONBURG RD, SUITE 350, SAINT MARYS, PA 15857-3483
(814) 781-8669
(814) 781-8671
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD056864L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019212650001
—
PA
Enumeration date
10/10/2007
Last updated
07/29/2008
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