| NPI | 1659885754 | 
|---|---|
| Doing Business As | PROVIDENCE UROLOGY SPECIALISTS | 
| Entity Type | Organization | 
| Authorized Contact | SARA L MILLER Director 615-920-7514 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 208800000X Urology | 
| Additional Taxonomies | 2085R0001X | 
| Enumeration Date | 2017-11-28 | 
| Last Update Date | 2018-12-17 |