Provider Demographics
NPI:1861530909
Name:GENITO URINARY SURGEONS, INC
Entity type:Organization
Organization Name:GENITO URINARY SURGEONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:I
Authorized Official - Last Name:TAPPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-531-8558
Mailing Address - Street 1:3500 EXECUTIVE PKWY
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1319
Mailing Address - Country:US
Mailing Address - Phone:419-531-8558
Mailing Address - Fax:
Practice Address - Street 1:3500 EXECUTIVE PKWY
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1319
Practice Address - Country:US
Practice Address - Phone:419-531-8558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0189180001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHGE9916132Medicare ID - Type Unspecified