National Provider Identifier Database

NORTH GEORGIA UROLOGY CENTER PC INC
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

NORTH GEORGIA UROLOGY CENTER, PC, INC
1434 BROADRICK DRIVE
NORTH GEORGIA UROLOGY CENTER
DALTON, GA30720
Phone: 706-278-5961
Fax: 706-275-0280
Website:
Specialty Taxonomy Code
* Urology 208800000X

* Indicates primary specialty

NPI Profile & details for NORTH GEORGIA UROLOGY CENTER, PC, INC

NPI Number 1861413197
Legal business name
LBN
NORTH GEORGIA UROLOGY CENTER, PC, INC
Authorized official CLISTA TALLENT - (PRACTICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 07/21/2006
Last updated 10/04/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 050482
  • GA Medicaid: 00931312A
  • GA Medicaid: 429126502A
  • GA Medicaid: 8913681

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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