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SOUTHERN INDIANA UROLOGIC CLINICLLC NPI 1407924053


NPI Information

NPI: 1407924053
Provider Name: SOUTHERN INDIANA UROLOGIC CLINIC,LLC
Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 15D0915854

Address:
2475 N PARK DR STE 10
COLUMBUS, IN
ZIP 47203
Phone: (812) 376-9261
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SOUTHERN INDIANA UROLOGIC CLINIC,LLC is an urology in Columbus, IN. The provider is 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. SOUTHERN INDIANA UROLOGIC CLINIC,LLC NPI is 1407924053. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2475 N PARK DR STE 10
COLUMBUS, IN
ZIP 47203-215
Phone: (812) 376-9261
Fax: (812) 378-9518

The provider's authorized official is Karl J Mcaleese .
The authorized official title is Owner and has the following contact phone number (812) 376-9261.

The CLIA number assigned to this NPI record is 15D0915854 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/1/2006 and was last updated on 1/27/2011.


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
1208800000XUrologyYes

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
1183650MEDICARE PININDIANA
2200328660MEDICAIDINDIANA

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

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