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Organization

WAYNE UROLOGICAL ASSOCIATES PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN VICTOR KASPAR M.D. (VICE PRESIDENT)
(919) 735-1635
Entity
Organization

Contact information

Practice address
1112 GRACIE PLACE, GOLDSBORO, NC 27534-2260
(919) 735-1635
(919) 735-6699
Mailing address
1112 GRACIE PLACE, GOLDSBORO, NC 27534-2260
(919) 735-1635
(919) 735-6699

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
208800000X
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8902910
NC
Enumeration date
04/11/2006
Last updated
07/06/2010
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