MEDICARE: COLUMBIA UROLOGICAL ASSOCIATES, P.A.

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	174400000X	Specialist

General Provider Information

NPI Number	:	1881809614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBIA UROLOGICAL ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	1407 HATCHER LN
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-3535
Country	:	US
Telephone Number	:	931-381-2110
Fax Number	:	931-381-5178

Provider Business Practice Location Address
First Line	:	1407 HATCHER LN
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-3535
Country	:	US
Telephone Number	:	931-381-2110
Fax Number	:	931-381-5178

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	DEBBIE MCNEAL
Credential	:
Telephone Number	:	931-381-2110

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	03/06/2008

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