Champion Urology LTD
Organization Active NPI Urology Physician · Westerly, RI
NPI 1013925965 · NPPES record last updated Apr 25, 2008
Key facts
- NPI
- 1013925965
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urology Physician 208800000X
- License
- 7511 (RI)
- Legal business name
- CHAMPION UROLOGY LTD
- Practice address
- 35 Wells Street
Westerly, RI 02891 - Phone
- (401) 596-0964
- Fax
- (401) 596-8634
- NPI assigned
- Aug 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Constance Lin Lutzel
- Title
- Office Manager
- Phone
- (401) 596-0964
National Provider Directory
Locations
35 Wells St
Westerly, RI 02891
Phone (401) 596-0964
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician |
208800000X | 7511 | RI | Yes |
| Urology Physician |
208800000X | 10831 | RI | |
| Urology Physician |
208800000X | 040289 | CT |
Addresses
Primary practice location
35 Wells Street
Westerly, RI 02891
Mailing address
35 Wells St
Westerly, RI 02891-2922
Phone (401) 596-0964
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003114204 | Medicaid | CT | |
| CU43922 | Medicaid | RI |
Other providers in Westerly, RI
- Marnie Hetu Casady
- Nicole Christine Ceil-Shepherdson
- Patricia Cervera
- Paulette L Chamberas
- Janice E Chamberlain
- Collin Chapin
- Melanie Chenette
- Jessica Cherenza
- Elaine Chicoria
- Childrens Dentistry of Ri LLC
All providers in Westerly, RI · Urology Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.