Organization
THE UROLOGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNN DILLS CMPE (BUSINESS MANAGER)
(706) 543-2718
Entity
Organization
Contact information
Practice address
120 TRINITY PL, ATHENS, GA 30607-2100
(706) 543-2718
(706) 353-3709
Mailing address
868 MICHAEL ETCHISON RD, SUITE A, MONROE, GA 30655-8204
(706) 543-2718
(706) 353-3709
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP814
MEDICARE
GA
Enumeration date
05/28/2008
Last updated
05/28/2008
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