CORPORATE LAKES UROLOGY LLC NPI 1124482187

NPI Details

CORPORATE LAKES UROLOGY, LLC is an urology in Overland Park, KS. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. CORPORATE LAKES UROLOGY, LLC NPI is 1124482187. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6740 W 121ST ST
SUITE 350
OVERLAND PARK, KS
ZIP 66209-002
Phone: (913) 948-8365
Fax: (913) 541-1034

The provider's authorized official is Billy Burl Perry .
The authorized official title is Owner and has the following contact phone number (913) 948-8365.

The CLIA number assigned to this NPI record is 26D0687479 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/6/2016 and was last updated on 4/6/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available: