Provider Demographics
NPI:1063549582
Name:UROLOGY INSTITUTE
Entity type:Organization
Organization Name:UROLOGY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:F
Authorized Official - Last Name:TRABUCCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACS
Authorized Official - Phone:775-356-9393
Mailing Address - Street 1:2385 E PRATER WAY SUITE 102
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434
Mailing Address - Country:US
Mailing Address - Phone:775-359-7008
Mailing Address - Fax:775-359-7010
Practice Address - Street 1:2385 E PRATER WAY SUITE 112
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434
Practice Address - Country:US
Practice Address - Phone:775-359-7008
Practice Address - Fax:775-356-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12132208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1104892611OtherNPI NUMBER
IN1104892611OtherNPI NUMBER
NVB58468Medicare UPIN