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Organization

THAMES UROLOGY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE S WOODS (PRACTICE MANAGER)
(860) 443-0622
Entity
Organization

Contact information

Practice address
3 SHAW'S COVE, SUITE 206, NEW LONDON, CT 06320
(860) 443-0622
(860) 443-5531
Mailing address
3 SHAW'S COVE, SUITE 206, NEW LONDON, CT 06320
(860) 443-0622
(860) 443-5531

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C02905
FIRST COAST SERV. OPTIONS MEDICARE PART B GOUP ID
Enumeration date
07/09/2006
Last updated
02/04/2010
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