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Organization

UNIVERSITY UROLOGISTS, INC., PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL O KOCH MD (PRESIDENT)
(317) 944-7338
Entity
Organization

Contact information

Practice address
535 BARNHILL DR STE 420, INDIANAPOLIS, IN 46202-5116
(317) 278-1979
(317) 278-1981
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
(888) 484-3258

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01048495A
IN
2088P0231X
Pediatric Urology Physician
01048495A
IN
363LP0200X
Pediatric Nurse Practitioner
71001248A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100057570
IN
Enumeration date
05/15/2006
Last updated
01/19/2024
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