Healthcare Provider Details

I. General information

NPI: 1437364973
Provider Name (Legal Business Name): NORBERT K URBANSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11518 N FRONTAGE RD
YUMA AZ
85367-8994
US

IV. Provider business mailing address

PO BOX 669
YUMA AZ
85366-2329
US

V. Phone/Fax

Practice location:
  • Phone: 928-342-6500
  • Fax:
Mailing address:
  • Phone: 928-342-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number37187
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number45596
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number66535
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: