Organization
PROGRESSIVE UROLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAREY BERNARD RANSONE M.D. (PRESIDENT)
(219) 324-3120
Entity
Organization
Contact information
Practice address
1505 STATE ST, LA PORTE, IN 46350-3115
(219) 324-3120
(219) 362-3743
Mailing address
1505 STATE ST, LA PORTE, IN 46350-3115
(219) 324-3120
(219) 362-3743
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01045023
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200091080
—
IN
Enumeration date
11/10/2007
Last updated
11/10/2007
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