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General NPI Number Information
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NPI Number | 1215724745
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Entity Type | Organization
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Legal Business Name | OASIS HEALTH UROLOGY, PLLC
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 932 SPRING ST STE 101
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City | PETOSKEY
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State | MI
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Zip | 49770-2286
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Country | US
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Telephone | 231-489-8298
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Fax | 231-489-8299
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Provider Business Mailing Address
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Address Line | 932 SPRING ST STE 101
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City | PETOSKEY
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State | MI
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Zip | 49770-2286
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Country | US
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Telephone | 231-489-8298
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Fax | 231-489-8299
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Authorized Official
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Title or Position | OWNER
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Name | KYLE MATTHEW WAISANEN
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Credential | MD
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Telephone | 231-489-8298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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