Tri-State Urology, P.C.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

7831 Issued in AL

Legal business name

TRI-STATE UROLOGY, P.C.

Practice address

4300 W Main St
Suite 102
Dothan, AL 36305-1054

Phone

(334) 793-9564

Fax

(334) 671-8907

NPI assigned

Dec 2, 2015

Last updated

Dec 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Melissa W Reeves

Title

Administrator

Phone

(334) 793-9564

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1336514389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W MAIN ST",
            "address_2": "SUITE 102",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051054",
            "telephone_number": "334-793-9564",
            "fax_number": "334-671-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W MAIN ST",
            "address_2": "SUITE 102",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051054",
            "telephone_number": "334-793-9564",
            "fax_number": "334-671-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE UROLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-793-9564",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AL",
            "license": "7831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Urology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.