Coastal Urology Center, PA

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

COASTAL UROLOGY CENTER, PA

Practice address

394 Singleton Ridge Rd
Conway, SC 29526-9150

Phone

(843) 347-8765

Fax

(843) 347-3466

NPI assigned

May 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Joseph Quillen, M.D.

Title

President

Phone

(843) 347-8765

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528010378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "394 SINGLETON RIDGE RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269150",
            "telephone_number": "843-347-8765",
            "fax_number": "843-347-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 SINGLETON RIDGE RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269150",
            "telephone_number": "843-347-8765",
            "fax_number": "843-347-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL UROLOGY CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "QUILLEN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-347-8765",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Neuropsychiatry, PA
• Coastal Orthopedic Associates, PA
• Coastal Pediatrics
• Coastal Pediatrics
• Coastal Podiatry Associates PA
• Coastline Ambulance LLC
• John Oliver Cochran, D.C.
• Rebecca Marie Cochran, MSW
• John Michael Coffman, RPH
• Robert L Coffman Jr.

• Urology Physician in Conway, SC
• Providers in Conway, SC by specialty
• Urology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.