Provider Demographics
NPI:1316902836
Name:KINSTON UROLOGICAL ASSOCIATES, PA
Entity type:Organization
Organization Name:KINSTON UROLOGICAL ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-527-3043
Mailing Address - Street 1:701 DOCTORS DR
Mailing Address - Street 2:SUITE L
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1584
Mailing Address - Country:US
Mailing Address - Phone:252-527-3043
Mailing Address - Fax:252-527-1348
Practice Address - Street 1:701 DOCTORS DR
Practice Address - Street 2:SUITE L
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1584
Practice Address - Country:US
Practice Address - Phone:252-527-3043
Practice Address - Fax:252-527-1348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01965OtherGROUP BCBS PROVIDER
NC8901965Medicaid
NC8901965Medicaid