MIDTOWN UROLOGY SURGICAL CENTER PC NPI 1902852841

NPI Information

NPI: 1902852841
Provider Name: MIDTOWN UROLOGY SURGICAL CENTER, PC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 11D0258685

Address:
1924 PIEDMONT RD NE
ATLANTA, GA
ZIP 30324
Phone: (404) 881-0966
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MIDTOWN UROLOGY SURGICAL CENTER, PC is an ambulatory surgical clinic center in Atlanta, GA. MIDTOWN UROLOGY SURGICAL CENTER, PC NPI is 1902852841. The provider is registered as an organization entity type.

The provider's business location address is:

1924 PIEDMONT RD NE
ATLANTA, GA
ZIP 30324-117
Phone: (404) 881-0966
Fax: (404) 874-5902

The provider's authorized official is James Kent Bennett .
The authorized official title is President and has the following contact phone number (404) 881-0966.

The CLIA number assigned to this NPI record is 11D0258685 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/25/2006 and was last updated on 7/21/2022.

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
1	261QA1903X	Clinic/Center	Ambulatory Surgical		GEORGIA	Yes

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
1	000659821A	MEDICAID	GEORGIA

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: 5/5/2024

NPI Synchronization or Removal

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