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General NPI Number Information
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NPI Number | 1790634103
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Entity Type | Organization
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Legal Business Name | CLINICAL UROLOGY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 133 WALL ST
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City | ALBERTVILLE
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State | AL
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Zip | 35951-9300
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Country | US
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Telephone | 256-492-4040
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Fax | 256-492-4017
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Provider Business Mailing Address
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Address Line | 713 GOODYEAR AVE
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City | GADSDEN
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State | AL
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Zip | 35903-1156
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Country | US
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Telephone | 256-492-4040
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Fax | 256-492-4017
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Authorized Official
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Title or Position | PRACTICE CREDENTIALING MANAGER
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Name | KOURTNEY MAYO FORD
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Credential |
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Telephone | 256-492-4040
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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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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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