Healthcare Provider Details

I. General information

NPI: 1427175512
Provider Name (Legal Business Name): RICHARD DEAN URWILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16136 W GALLERIA LN
SURPRISE AZ
85374
US

IV. Provider business mailing address

16136 W GALLERIA LN
SURPRISE AZ
85374
US

V. Phone/Fax

Practice location:
  • Phone: 623-546-0805
  • Fax:
Mailing address:
  • Phone: 623-546-0805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number14087INACTIVE
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number9996ACTIVE
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: