Provider Demographics
NPI:1144309048
Name:MIDWEST UROLOGY, INC.
Entity type:Organization
Organization Name:MIDWEST UROLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-745-9799
Mailing Address - Street 1:10495 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4468
Mailing Address - Country:US
Mailing Address - Phone:513-745-9799
Mailing Address - Fax:513-745-9796
Practice Address - Street 1:10495 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4468
Practice Address - Country:US
Practice Address - Phone:513-745-9799
Practice Address - Fax:513-745-9796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9312453Medicare PIN
OH9312456Medicare PIN
OH9312454Medicare PIN
OH9312459Medicare PIN
OH9312451Medicare PIN
IN186150Medicare PIN
OH9312455Medicare PIN
OH9312458Medicare PIN