MEDICARE: ASSOCIATED UROLOGISTS, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician

General Provider Information

NPI Number	:	1760453674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATED UROLOGISTS, PA

Provider Business Mailing Address
First Line	:	1133 COLLEGE AVE
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502-2770
Country	:	US
Telephone Number	:	785-537-8710
Fax Number	:	785-537-0562

Provider Business Practice Location Address
First Line	:	1133 COLLEGE AVE
Second Line	:	BLDG G SUITE 100
City	:	MANHATTAN
State	:	KS
Zip	:	66502-2756
Country	:	US
Telephone Number	:	785-537-8710
Fax Number	:	785-537-0562

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN P DEVINE
Credential	:	MD
Telephone Number	:	785-537-8710

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	02/25/2020

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