Organization
AIKEN CENTER FOR UROLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN ANDERSON (PRESIDENT)
(803) 649-3903
Entity
Organization
Contact information
Practice address
770 MEDICAL PARK DR, AIKEN, SC 29801-6307
(803) 642-6161
(803) 642-6161
Mailing address
770 MEDICAL PARK DR, AIKEN, SC 29801-6307
(803) 642-6161
(803) 642-6161
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4148
—
SC
Enumeration date
11/01/2006
Last updated
09/13/2010
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