Organization
UROLOGICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE BACK (OFFICE MANAGER)
(740) 344-1516
Entity
Organization
Contact information
Practice address
1902 TAMARACK RD, NEWARK, OH 43055-2303
(740) 344-1516
(740) 344-3514
Mailing address
1902 TAMARACK RD, NEWARK, OH 43055-2303
(740) 344-1516
(740) 344-3514
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114316
—
OH
01
—
CI8197
MEDICARE RAILROAD
OH
Enumeration date
11/01/2007
Last updated
11/07/2007
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