360 UROLOGY NPI 1871336669

NPI Information

  • NPI: 1871336669
  • Provider Name: 360 UROLOGY
  • Classification: Urology - 208800000X
  • Entity Type: Organization
  • CLIA Number: 11D2308483
  • Address: 175 COUNTRY CLUB DR STE 300-E
    STOCKBRIDGE, GA
    ZIP 30281
  • Phone: (678) 941-4140

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NPI Details

360 UROLOGY is an urology in Stockbridge, 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. 360 UROLOGY NPI is 1871336669. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

175 COUNTRY CLUB DR STE 300-E
STOCKBRIDGE, GA
ZIP 30281-054
Phone: (678) 941-4140
Fax: (678) 941-4139

The provider's authorized official is Bhavik B Shah .
The authorized official title is Owner and has the following contact phone number (813) 842-5956.

The CLIA number assigned to this NPI record is 11D2308483 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/18/2024 and was last updated on 7/26/2024.

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

What is NPI?

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

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