MEDICARE: UNIVERISTY UROLOGY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	19584	KY

General Provider Information

NPI Number	:	1508889957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERISTY UROLOGY, PLLC

Provider Business Mailing Address
First Line	:	234 E GRAY ST
Second Line	:	SUITE 662
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1900
Country	:	US
Telephone Number	:	502-629-4220
Fax Number	:	502-629-4223

Provider Business Practice Location Address
First Line	:	234 E GRAY ST
Second Line	:	SUITE 662
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1900
Country	:	US
Telephone Number	:	502-629-4220
Fax Number	:	502-629-4223

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	DR. ANTHONY J CASALE
Credential	:	M.D.
Telephone Number	:	502-629-4220

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	08/22/2020

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