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General NPI Number Information
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NPI Number | 1770531931
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Entity Type | Organization
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Legal Business Name | NEW ALBANY UROLOGY, PLLC
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 303 J. H. PHILLIPS LANE
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City | NEW ALBANY
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State | MS
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Zip | 38652-2428
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Country | US
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Telephone | 662-539-0233
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Fax | 662-538-0996
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Provider Business Mailing Address
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Address Line | PO BOX 777
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City | NEW ALBANY
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State | MS
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Zip | 38652-0777
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Country | US
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Telephone | 662-539-0233
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Fax | 662-538-0996
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Authorized Official
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Title or Position | OWNER
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Name | DR. BENJAMIN BERNSTEIN
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Credential | M.D.
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Telephone | 662-539-0233
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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 | 17918
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License Number State | MS
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