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General NPI Number Information
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NPI Number | 1053346064
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Entity Type | Organization
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Legal Business Name | UROLOGY GROUP PC
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 7550 WOLF RIVER BLVD STE 200
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City | GERMANTOWN
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State | TN
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Zip | 38138-1778
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Country | US
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Telephone | 901-767-8158
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Fax |
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Provider Business Mailing Address
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Address Line | 7550 WOLF RIVER BLVD STE 200
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City | GERMANTOWN
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State | TN
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Zip | 38138-1778
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Country | US
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Telephone | 901-767-8158
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Fax | 901-767-1555
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | ANGIE WILSON
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Credential |
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Telephone | 901-767-8158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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