National Provider Identifier Database

EDENTON UROLOGY CLINIC
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.


Contact Information

EDENTON UROLOGY CLINIC
210 N BROAD ST
EDENTON, NC27932
Phone: 252-482-1606
Fax: 252-482-1611
Website:
Specialty Taxonomy Code
* Urology 208800000X

* Indicates primary specialty

NPI Profile & details for EDENTON UROLOGY CLINIC

NPI Number 1578630398
Legal business name
LBN
EDENTON UROLOGY CLINIC
Authorized official JOEL REYNOLDS - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 11/29/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • NC License #: 9900331
  • NC Medicaid: 790289T
  • Other: 0289T BCBS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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