MEDICARE: UROLOGICAL CLINIC OF VALDOSTA

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	261QM2500X	Medical Specialty Clinic/Center	018627	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1032904	OTHER		NCCPA

General Provider Information

NPI Number	:	1558341057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UROLOGICAL CLINIC OF VALDOSTA

Provider Business Mailing Address
First Line	:	7494 EULIE WOOD DR
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31601-1144
Country	:	US
Telephone Number	:	229-247-9124
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 N PATTERSON ST
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-1711
Country	:	US
Telephone Number	:	229-241-1188
Fax Number	:	229-245-7106

Authorized Official
Title or Position	:	PHYSICIAN ASSISTANT
Name	:	MR. DAVID ERIC EATON
Credential	:	MPAS
Telephone Number	:	229-242-9003

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1104792704 — BRYSON SIMPSON FNP-C
Practice Location Address:

3014 N PATTERSON ST
VALDOSTA, GA
31602-1711

Practice Phone: 229-262-6815
Practice Fax: 229-219-1790

1780681544 — DR. ALBERT GONZALEZ-ACEVEDO M.D.
Practice Location Address:

3024 N PATTERSON ST
VALDOSTA, GA
31602-1711

Practice Phone: 229-247-4114
Practice Fax: 229-245-9042

1124018759 — C HEATHER COLSON DMD PC
Practice Location Address:

3000 N PATTERSON ST
VALDOSTA, GA
31602-1711

Practice Phone: 229-242-2449
Practice Fax: 229-242-2699

1548274129 — BEN H MOYE M.D.
Practice Location Address:

3024 N PATTERSON ST
VALDOSTA, GA
31602-1711

Practice Phone: 229-247-4114
Practice Fax: 229-245-9042

1619982485 — CLIFFORD D COURTENAY O.D.
Practice Location Address:

3024 N PATTERSON ST
VALDOSTA, GA
31602-1711

Practice Phone: 229-247-4114
Practice Fax: 229-245-9042

1609882091 — DR. JANICE HOLLY LOEFFLER MD
Practice Location Address:

3014 N PATTERSON ST
VALDOSTA, GA
31602-1711

Practice Phone: 229-242-0194
Practice Fax: 229-242-1785

Directions to “UROLOGICAL CLINIC OF VALDOSTA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.