Provider Demographics
NPI:1326093147
Name:UROLOGY ASSOCIATES, LLC
Entity type:Organization
Organization Name:UROLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:KAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-914-9253
Mailing Address - Street 1:141 W 22ND ST STE 213
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016-4389
Mailing Address - Country:US
Mailing Address - Phone:765-289-7444
Mailing Address - Fax:765-289-8628
Practice Address - Street 1:141 W 22ND ST STE 213
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-4389
Practice Address - Country:US
Practice Address - Phone:765-289-7444
Practice Address - Fax:765-289-8628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200066660 AMedicaid
IN200066660Medicaid
IN200066660 AMedicaid
1260720001Medicare NSC