Enid Urology Associates

Organization Active NPI Urology Physician · Arkansas City, KS

NPI 1871820175 · NPPES record last updated Aug 10, 2011

Key facts

NPI
1871820175
Entity type
Organization (NPI type 2)
Primary specialty
Urology Physician 208800000X
License
0434000 (KS)
Legal business name
ENID UROLOGY ASSOCIATES
Practice address
6401 Patterson Pkwy
Arkansas City, KS 67005-5701
Phone
(580) 233-3230
Fax
(580) 233-0698
NPI assigned
Nov 6, 2009
Organization subpart
Yes
Parent organization (as reported)
ENID UROLOGY ASSOCIATES, INC

Authorized official

Name
Dr. Jarrett D Kruska, MD
Title
Owner
Phone
(580) 233-3230

Corporate family (same tax ID) 2

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

National Provider Directory

Tax ID family
Roger W Timmpa (3 organizations share this tax ID)
Part of
Roger W Timmpa

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208800000X 0434000 KS Yes

Addresses

Primary practice location

6401 Patterson Pkwy
Arkansas City, KS 67005-5701

Mailing address

615 E Oklahoma Ave
Ste 202
Enid, OK 73701-5951
Phone (580) 233-3230

Other identifiers

IdentifierTypeStateIssuer
0361060001OtherOKMEDICARE DME
200057980AMedicaidOK

Other providers in Arkansas City, KS

All providers in Arkansas City, KS · Urology Physician in Kansas

Sources for this page

Verify at the official NPI Registry.