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General NPI Number Information
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NPI Number | 1912081878
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Entity Type | Organization
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Legal Business Name | UROLOGY ONE INC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 1330 MERCY DR NW STE 510
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City | CANTON
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State | OH
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Zip | 44708
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Country | US
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Telephone | 330-456-6760
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Fax | 330-452-4557
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Provider Business Mailing Address
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Address Line | 1330 MERCY DR NW STE 510
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City | CANTON
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State | OH
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Zip | 44708-2625
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Country | US
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Telephone | 330-456-6760
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Fax | 330-452-4557
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BECHARA G TABET
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Credential | MD
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Telephone | 330-456-6760
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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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