Tri-County Urology Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD056864L Issued in PA

Legal business name

TRI-COUNTY UROLOGY INC

Practice address

761 Johnsonburg Rd
Suite 350
Saint Marys, PA 15857-3483

Phone

(814) 781-8669

Fax

(814) 781-8671

NPI assigned

Oct 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Donald H Rudick, MD

Title

President

Phone

(814) 781-8669

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1053509513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 JOHNSONBURG RD",
            "address_2": "SUITE 350",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158573483",
            "telephone_number": "814-781-8669",
            "fax_number": "814-781-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 JOHNSONBURG RD",
            "address_2": "SUITE 350",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158573483",
            "telephone_number": "814-781-8669",
            "fax_number": "814-781-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY UROLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "RUDICK",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-781-8669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "PA",
            "license": "MD056864L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019212650001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Saint Marys, PA
• Providers in Saint Marys, PA by specialty
• Urology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.