Southern Urological Associates

Primary specialty

SpecialistTaxonomy code 174400000X

License

058647 Issued in GA

Legal business name

SOUTHERN UROLOGICAL ASSOCIATES

Practice address

2805 N Oak St
Suite B
Valdosta, GA 31602-5922

Phone

(229) 316-2990

Fax

(229) 259-9547

NPI assigned

Dec 27, 2007

Last updated

Dec 27, 2007By 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

Dr. Jacek T Sosnowski, M.DNPI 1659362192

Title

Owner

Phone

(229) 316-2990

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacek T Sosnowski, MD

  • Urology Physician
  • Amherst, NY
  • NPI 1659362192
  Authorized official Same address or phone

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1861676892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 N OAK ST",
            "address_2": "SUITE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316025922",
            "telephone_number": "229-316-2990",
            "fax_number": "229-259-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 N OAK ST",
            "address_2": "SUITE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316025922",
            "telephone_number": "229-316-2990",
            "fax_number": "229-259-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN UROLOGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "SOSNOWSKI",
        "authorized_official_first_name": "JACEK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-316-2990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "058647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.