Organization
UROLOGIC PHYSICIANS & SURGEONS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK R PENCE II MD (PRESIDENT)
(937) 429-7352
Entity
Organization
Contact information
Practice address
2145 N FAIRFIELD RD, SUITE B, BEAVERCREEK, OH 45431-2580
(937) 429-7352
(937) 429-3772
Mailing address
2145 N FAIRFIELD RD, SUITE B, BEAVERCREEK, OH 45431-2580
(937) 429-7352
(937) 429-3772
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2426100
—
OH
Enumeration date
07/12/2005
Last updated
07/21/2022
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