NPIMap

Organization Active NPI

Southeast Arizona Urology Care

  • Urology Physician
  • Sierra Vista, AZ
National Provider Identifier
1821292988
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
27092 Issued in AZ
Legal business name
SOUTHEAST ARIZONA UROLOGY CARE
Practice address
3533 Canyon de Flores Ste a
Sierra Vista, AZ 85650-5366
Phone
(520) 803-7640
Fax
(520) 803-7886
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Authorized official

Name
Mr. Gary William Terry
Title
Ceo
Phone
(520) 803-7640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 27092 AZ Primary

Addresses

Primary practice location

3533 Canyon de Flores Ste a
Sierra Vista, AZ 85650-5366

Mailing address

3533 Canyon de Flores Ste a
Sierra Vista, AZ 85650-5366
Phone (520) 803-7640

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362960000000",
    "number": "1821292988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 CANYON DE FLORES STE A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856505366",
            "telephone_number": "520-803-7640",
            "fax_number": "520-803-7886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 CANYON DE FLORES STE A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856505366",
            "telephone_number": "520-803-7640",
            "fax_number": "520-803-7886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ARIZONA UROLOGY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2013-03-11",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-803-7640",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "AZ",
            "license": "27092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; 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.