Organization
KOKOMO UROLOGY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIS W PEELLE M.D. (PRESIDENT)
(765) 455-4075
Entity
Organization
Contact information
Practice address
2345 W LINCOLN RD, KOKOMO, IN 46902-8012
(765) 455-4075
(765) 455-4094
Mailing address
2345 W LINCOLN RD, KOKOMO, IN 46902-8012
(765) 455-4075
(765) 455-4094
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100136840A
—
IN
Enumeration date
07/18/2007
Last updated
05/12/2008
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