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General NPI Number Information
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NPI Number | 1568666287
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Entity Type | Organization
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Legal Business Name | OCALA UROLOGY SPECIALISTS PA
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 08/09/2010
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Provider Practice Location Address
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Address Line | 2850 SE 3RD CT
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City | OCALA
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State | FL
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Zip | 34471-0440
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Country | US
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Telephone | 352-732-6474
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Fax | 352-732-7205
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Provider Business Mailing Address
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Address Line | 2850 SE 3RD CT
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City | OCALA
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State | FL
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Zip | 34471-0440
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Country | US
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Telephone | 352-732-6474
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Fax | 352-732-7205
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES T KING
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Credential | M.D.
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Telephone | 352-732-6474
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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 | ME0050759
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License Number State | FL
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