MEDICARE: KNOX UROLOGY INC

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	35042634	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0449982	OTHER	OH	MEDICARE
3	0449981	OTHER	OH	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619013877
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KNOX UROLOGY INC

Provider Business Mailing Address
First Line	:	812 COSHOCTON AVE
Second Line	:
City	:	MT VERNON
State	:	OH
Zip	:	43050-1947
Country	:	US
Telephone Number	:	740-397-7220
Fax Number	:	740-397-0682

Provider Business Practice Location Address
First Line	:	812 COSHOCTON AVE
Second Line	:
City	:	MT VERNON
State	:	OH
Zip	:	43050-1947
Country	:	US
Telephone Number	:	740-397-7220
Fax Number	:	740-397-0682

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RAMANADHARAO PAMULAPATI
Credential	:	MD
Telephone Number	:	740-397-7220

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	08/22/2020

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Directions to “KNOX UROLOGY INC ” Practice Location

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