NPIMap

Organization Active NPI

Georgia Urology PA

  • Urology Physician
  • Decatur, GA
National Provider Identifier
1467628586
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
GEORGIA UROLOGY PA
Practice address
2685 Milscott Dr
Decatur, GA 30033-5906
Phone
(404) 292-3727
Fax
(404) 294-9674
NPI assigned
May 8, 2008
Organization subpart
Yes
Parent organization
GEORGIA UROLOGY PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Authorized official

Name
Mark A Haber, M.D.
Title
Managing Partner
Phone
(678) 284-4049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

2685 Milscott Dr
Decatur, GA 30033-5906

Mailing address

1930 Brannan Rd
McDonough, GA 30253-4310
Phone (678) 284-4040

National Provider Directory

National Provider Directory
Tax ID family
Georgia Urology Infertility Services2 organizations share this tax ID, including this one
Part of
Georgia Urology

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1467628586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040",
            "fax_number": "678-284-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 MILSCOTT DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335906",
            "telephone_number": "404-292-3727",
            "fax_number": "404-294-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA UROLOGY PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA UROLOGY PA",
        "enumeration_date": "2008-05-08",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "HABER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "678-284-4049",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.