MODERN UROLOGY INC. NPI 1881799971

NPI Information

NPI: 1881799971
Provider Name: MODERN UROLOGY, INC.
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1400 US HIGHWAY 61
SUITE 250
FESTUS, MO
ZIP 63028
Phone: (636) 239-7559
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MODERN UROLOGY, INC. is a specialist in Festus, MO. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MODERN UROLOGY, INC. NPI is 1881799971. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1400 US HIGHWAY 61
SUITE 250
FESTUS, MO
ZIP 63028-100
Phone: (636) 239-7559
Fax: (636) 239-6947

The provider's authorized official is Erik Houttuin .
The authorized official title is President and has the following contact phone number (636) 239-7559.

The enumeration date for this NPI number is 9/13/2006 and was last updated on 2/2/2009.

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	174400000X	Specialist		35745	MISSOURI	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	505763615	MEDICAID	MISSOURI
2	000013309	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI	PROVIDER NUMBER AREA 99
3	000013310	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI	PROVIDER NUMBER AREA 1
4	200000107	MEDICAID	MISSOURI
5	A11109	MEDICARE UPIN	MISSOURI
6	505763607	MEDICAID	MISSOURI

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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