MEDICARE: UROLOGY ASSOCIATES PC

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

General Provider Information

NPI Number	:	1881110500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UROLOGY ASSOCIATES PC

Provider Business Mailing Address
First Line	:	2801 CHARLOTTE AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-4035
Country	:	US
Telephone Number	:	615-250-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 GLEN OAK BLVD STE 100
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-3161
Country	:	US
Telephone Number	:	615-250-9200
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE ADMINSTRATOR
Name	:	MICAIL SAMIERE
Credential	:
Telephone Number	:	615-250-9200

Provider Enumeration Date	:	08/15/2017
Last Update Date	:	08/15/2017

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