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General NPI Number Information
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NPI Number | 1902940034
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Entity Type | Organization
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Legal Business Name | ADVANCED UROLOGY ASSOCIATES PC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 395 NORTHWOOD DR
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City | CENTRE
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State | AL
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Zip | 35960-1045
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Country | US
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Telephone | 256-927-7791
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Fax | 256-927-9156
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Provider Business Mailing Address
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Address Line | 303 BAY ST SUITE 101
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City | GADSDEN
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State | AL
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Zip | 35901-5265
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Country | US
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Telephone | 256-543-1188
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Fax | 256-543-8855
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE PHILIPS WALKER
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Credential | MD
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Telephone | 256-543-1188
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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 | 3279
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License Number State | AL
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