NPIMap

Academic Urology of PA LLC

Organization Active NPI Urology Physician · King of Prussia, PA

NPI 1063769701 · NPPES record last updated Mar 2, 2020

Key facts

NPI
1063769701
Entity type
Organization (NPI type 2)
Primary specialty
Urology Physician 208800000X
License
MD031222E (PA)
Legal business name
ACADEMIC UROLOGY OF PA LLC
Practice address
211 S Gulph Rd
Suite 200
King of Prussia, PA 19406-3112
Phone
(610) 382-5910
Fax
(610) 382-5918
NPI assigned
Aug 13, 2012
Organization subpart
No

Authorized official

Name
David Adams
Title
Coo
Phone
(610) 382-5900

Corporate family (same tax ID) 12

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Centers for Advanced Urology LLC (13 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208800000X MD031222E PA Yes

Addresses

Primary practice location

211 S Gulph Rd
Suite 200
King of Prussia, PA 19406-3112

Mailing address

211 S Gulph Rd
Suite 200
King of Prussia, PA 19406-3112
Phone (610) 382-5910

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 2, 2020.

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1063769701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S GULPH RD",
            "address_2": "SUITE 200",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063112",
            "telephone_number": "610-382-5910",
            "fax_number": "610-382-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S GULPH RD",
            "address_2": "SUITE 200",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063112",
            "telephone_number": "610-382-5910",
            "fax_number": "610-382-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMIC UROLOGY OF PA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-13",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "610-382-5900"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "PA",
            "license": "MD031222E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

All providers in King of Prussia, PA · Urology Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.