GEORGIA UROLOGY PA NPI 1235354424

NPI Information

  • NPI: 1235354424
  • Provider Name: GEORGIA UROLOGY PA
  • Classification: Urology - 208800000X
  • Entity Type: Organization
  • CLIA Number: 11D0891563
  • Address: 220 J L WHITE DR
    SUITE 160
    JASPER, GA
    ZIP 30143
  • Phone: (706) 692-4384

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NPI Details

GEORGIA UROLOGY PA is an urology in Jasper, GA. 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. GEORGIA UROLOGY PA NPI is 1235354424. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

220 J L WHITE DR
SUITE 160
JASPER, GA
ZIP 30143-893
Phone: (706) 692-4384
Fax: (706) 692-2504

The provider's authorized official is Mark A Haber .
The authorized official title is Managing Partner and has the following contact phone number (678) 284-4049.

The CLIA number assigned to this NPI record is 11D0891563 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/15/2007 and was last updated on 1/28/2015.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208800000XUrologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10879130005MEDICARE NSCGEORGIA
211D0891563OTHERGEORGIACLIA
3GRP1552MEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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