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General NPI Number Information
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NPI Number | 1689607087
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Entity Type | Organization
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Legal Business Name | INTEGRITY UROLOGIC, SC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 707 S UNIVERSITY AVE
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City | BEAVER DAM
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State | WI
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Zip | 53916-3027
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Country | US
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Telephone | 920-887-7654
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Fax | 920-887-4818
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Provider Business Mailing Address
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Address Line | 707 S UNIVERSITY AVE
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City | BEAVER DAM
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State | WI
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Zip | 53916-3027
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Country | US
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Telephone | 920-887-7654
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Fax | 920-887-4818
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Authorized Official
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Title or Position | OWNER
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Name | JAMES CAULEY
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Credential | M.D.
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Telephone | 920-887-7654
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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 | 24484
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License Number State | WI
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