Organization
WOOSTER UROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL J CROWLEY M.D. (MANAGING PARTNER)
(330) 345-5533
Entity
Organization
Contact information
Practice address
546 WINTER ST, SUITE 210, WOOSTER, OH 44691-2300
(330) 345-5533
(330) 345-7659
Mailing address
546 WINTER ST, SUITE 210, WOOSTER, OH 44691-2300
(330) 345-5533
(330) 345-7659
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
35-090639
OH
208800000X
Urology Physician
Primary
57530
OH
2088P0231X
Pediatric Urology Physician
35-090639
OH
2088P0231X
Pediatric Urology Physician
57530
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0624801
MEDICARE PTAN
—
05
—
0714954
—
OH
05
—
2995497
—
OH
01
—
4266321
MEDICARE PTAN
—
Enumeration date
07/07/2011
Last updated
02/16/2012
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