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General NPI Number Information
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NPI Number | 1306211370
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Entity Type | Organization
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Legal Business Name | UROLOGY CENTER-USA INC
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Dates
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Enumeration Date | 12/02/2015
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 1830 TOWN CENTER DR SUITE 301
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City | RESTON
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State | VA
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Zip | 20190-3292
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Country | US
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Telephone | 703-742-7757
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Fax | 703-742-6857
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Provider Business Mailing Address
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Address Line | 1830 TOWN CENTER DR SUITE 301
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City | RESTON
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State | VA
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Zip | 20190-3292
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Country | US
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Telephone | 703-742-7757
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Fax | 703-742-6857
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Authorized Official
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Title or Position | PRES./CEO
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Name | DR. JANICE LEE ARNOLD
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Credential | MD
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Telephone | 703-742-7757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101040651
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License Number State | VA
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