Provider Demographics
NPI:1780891309
Name:UROLOGY ASSOCIATES OF SOUTH ARKANSAS
Entity type:Organization
Organization Name:UROLOGY ASSOCIATES OF SOUTH ARKANSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-536-5162
Mailing Address - Street 1:1609 W 40TH AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-6366
Mailing Address - Country:US
Mailing Address - Phone:870-536-5162
Mailing Address - Fax:870-536-5198
Practice Address - Street 1:1609 W 40TH AVE STE 301
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-6366
Practice Address - Country:US
Practice Address - Phone:870-536-5162
Practice Address - Fax:870-536-5198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty