Organization
TRI-STATE UROLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA W REEVES (ADMINISTRATOR)
(334) 793-9564
Entity
Organization
Contact information
Practice address
4300 W MAIN ST, SUITE 102, DOTHAN, AL 36305-1054
(334) 793-9564
(334) 671-8907
Mailing address
4300 W MAIN ST, SUITE 102, DOTHAN, AL 36305-1054
(334) 793-9564
(334) 671-8907
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
7831
AL
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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