Urologic Physicians & Surgeons Inc.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

UROLOGIC PHYSICIANS & SURGEONS INC.

Practice address

2145 N Fairfield Rd
Suite B
Beavercreek, OH 45431-2580

Phone

(937) 429-7352

Fax

(937) 429-3772

NPI assigned

Jul 12, 2005

Organization subpart

No

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

Authorized official

Name

Jack R Pence II, MD

Title

President

Phone

(937) 429-7352

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1528066602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 N FAIRFIELD RD",
            "address_2": "SUITE B",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312580",
            "telephone_number": "937-429-7352",
            "fax_number": "937-429-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 N FAIRFIELD RD",
            "address_2": "SUITE B",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312580",
            "telephone_number": "937-429-7352",
            "fax_number": "937-429-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGIC PHYSICIANS & SURGEONS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PENCE",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-429-7352",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2426100",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Urology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.