GEORGIA UROLOGY, PA (NPI# 1093369795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093369795 |
| Entity Type | Organization |
| Organization Name | GEORGIA UROLOGY, PA |
| Practice Address |
470 Northside Cherokee Blvd Ste 210 Canton GA 30115-8029 |
| Mailing Address |
1930 Brannan Rd Mcdonough GA 30253-4310 |
| Practice Telephone | 7707207246 |
| Mailing Telephone | 6782844040 |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2020-08-26 |
| Authorized Official Name | MARK A HABER (MANAGING PARTNER) |
| Authorized Official Telephone | 6782844040 |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA UROLOGY PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699328369 | Georgia Urology, Pa | Clinic/Center | 1670 Scott Blvd Ste 204k, Decatur, GA 30033-5645 | 2019-07-22 |
| 1952771230 | Georgia Urology, Pa | Clinic/Center | 3400 Old Milton Pkwy Ste C535, Alpharetta, GA 30005-4456 | 2015-09-30 |
| 1629222815 | Georgia Urology, Pa | Clinic/Center | 1301 Sigman Rd Ne Ste 250b, Conyers, GA 30012-3812 | 2008-11-14 |
| 1003428590 | Georgia Urology, Pa | Urology | 4150 Deputy Bill Cantrell Memorial Rd., Suite 140a, Cumming, GA 30040 | 2020-08-18 |
| 1245875236 | Georgia Urology, Pa | Urology | 631 Professional Dr Ste 490, Lawrenceville, GA 30046-3370 | 2019-11-13 |
| 1083268783 | Georgia Urology, Pa | Urology | 120 Trinity Pl, Athens, GA 30607-2100 | 2019-07-31 |
| 1639499627 | Georgia Urology, Pa | Clinic/Center | 790 Church St Ne, Suite 430, Marietta, GA 30060-7282 | 2010-06-02 |
| Street Address |
470 NORTHSIDE CHEROKEE BLVD STE 210 |
| City | CANTON |
| State | GA |
| Zip Code | 30115-8029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497364806 | Amanda Arbogast | Speech-Language Pathologist | 610 Royal Crest Court, Canton, GA 30115 | 2020-07-31 |
| 1033754163 | Kelly Marie Shirley | Nurse Practitioner | 450 Northside Cherokee Blvd., Radiology Dept., Canton, GA 30115 | 2019-11-13 |
| 1700394319 | Jennifer Lynn Davenport | Nurse Practitioner | 684 Sixes Rd Ste 125, Holly Springs, GA 30115 | 2018-01-17 |
| 1851717961 | Wal-mart Stores East, Lp | Technician/Technologist | 2200 Holly Springs Pkey, Holly Springs, GA 30115 | 2014-03-13 |
| 1194148502 | Julia Bedingfield Reid | Pharmacist | 450 Northside Cherokee Blvd Ste T20, Canton, GA 30115 | 2014-01-22 |
| 1447597992 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2030 Cumming Highway, Suite 106, Canton, GA 30115 | 2013-01-03 |
| 1679821193 | Jill M Decorso | Speech-Language Pathologist | 4280 Hickory Flat Hwy, Ste 108, Canton, GA 30115 | 2012-08-15 |
| 1306113378 | Sidney Boyd Collier IIi | Pharmacist | 6111 Hickory Flat Highway, Canton, GA 30115 | 2011-11-18 |
| 1174804702 | Rayllensons Itacy | Physician Assistant | 2020 Cumming Highway, Suite 102, Canton, GA 30115 | 2011-09-09 |
| 1245534346 | Kim M. Mcmillan | Counselor | 154 Lakeside Drive, Canton, GA 30115 | 2011-01-04 |
| Find all providers in zip 30115 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820576 | Advanced Urology Institute of Georgia PC | Urology | 2205 Riverstone Blvd Ste 101, Canton, GA 30114-5250 | 2020-04-23 |
| 1447592902 | Wesley Warren Ludwig | Urology | 145 Riverstone Ter Ste 101, Canton, GA 30114-5327 | 2013-03-22 |
| 1982712899 | Jack Ross Baker | Urology | 4590 Dressler Road Nw, Canton, OH 44718-2546 | 2006-08-29 |
| 1538277710 | Carl C Capelouto | Urology | 470 Northside Cherokee Blvd Ste 201, Canton, GA 30115-8029 | 2006-08-28 |
| 1144220807 | Steven E. Ochs | Urology | 1330 Mercy Dr. Nw, Suite 510, Canton, OH 44708 | 2005-07-26 |
| 1063410611 | Anthony Patrick Bertin | Urology | 4976 Tuscarawas St W, Canton, OH 44708-5057 | 2005-07-08 |
| 1063995264 | Katherine Anna Nixon | Urology | 2600 Tuscarawas St W Ste 400, Canton, OH 44708-4698 | 2018-09-13 |
| 1891227302 | Georgia Urology Pa | Urology | 470 Northside Cherokee Blvd Ste 201, Canton, GA 30115-8015 | 2017-04-03 |
| 1992147193 | Georgia Urology Pa | Urology | 320 Hospital Rd, Med Assoc of No Ga, Canton, GA 30114-2432 | 2013-07-29 |
| 1164795795 | Aultman Medical Group, Inc | Urology | 2600 Sixth St Sw, Canton, OH 44710-1702 | 2012-02-13 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.