Provider Demographics
NPI:1215724745
Name:OASIS HEALTH UROLOGY, PLLC
Entity type:Organization
Organization Name:OASIS HEALTH UROLOGY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:WAISANEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-489-8298
Mailing Address - Street 1:932 SPRING ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2286
Mailing Address - Country:US
Mailing Address - Phone:231-489-8298
Mailing Address - Fax:231-489-8299
Practice Address - Street 1:932 SPRING ST STE 101
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2286
Practice Address - Country:US
Practice Address - Phone:231-489-8298
Practice Address - Fax:231-489-8299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-21
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty