Cilinical Urology Associates, P.C.

Organization Active NPI Urology Physician · Oneonta, AL

NPI 1174300933 · NPPES record last updated Nov 17, 2023

Key facts

NPI
1174300933
Entity type
Organization (NPI type 2)
Primary specialty
Urology Physician 208800000X
Legal business name
CILINICAL UROLOGY ASSOCIATES, P.C.
Practice address
150 Gilbreath Dr
Oneonta, AL 35121-2827
Phone
(256) 492-4040
Fax
(256) 492-4017
NPI assigned
Sep 13, 2023
Organization subpart
Yes
Parent organization (as reported)
CILINICAL UROLOGY ASSOCIATES, P.C.

Authorized official

Name
Kourtney Mayo
Title
Credentialing/Admin Assist
Phone
(256) 492-4040

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 7

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040820000950 AL Part B Supplier - Clinic/Group Practice 0749254241 Receives reassigned benefits from 16 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pell City, AL; Oneonta, AL; Jacksonville, AL; Fort Payne, AL; Gadsden, AL; Albertville, AL

National Provider Directory

Tax ID family
Clinical Urology Assocs (8 organizations share this tax ID)
Part of
Clinical Urology Assocs

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208800000X Yes

Addresses

Primary practice location

150 Gilbreath Dr
Oneonta, AL 35121-2827

Mailing address

713 Goodyear Ave
Gadsden, AL 35903-1156
Phone (256) 492-4040

Other providers in Oneonta, AL

All providers in Oneonta, AL · Urology Physician in Alabama

Sources for this page

Verify at the official NPI Registry.