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Organization

UROLOGICAL CLINIC OF VALDOSTA PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MIKE SYRU CHIANG MD. (DOCTOR)
(229) 241-1188
Entity
Organization

Contact information

Practice address
3294 NORTH OAK ST. EXT., VALDOSTA, GA 31605
(229) 241-1188
(229) 245-7106
Mailing address
3294 NORTH OAK ST. EXT., VALDOSTA, GA 31605
(229) 241-1188
(229) 245-7106

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
018627
GA
174400000X
Specialist
18627
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000244791B
GA
01
340005901
MEDICARE RAILROAD
Enumeration date
05/01/2007
Last updated
07/05/2017
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