Provider Demographics
NPI:1427067263
Name:UROLOGY ASSOCIATES OF GREEN BAY, S.C.
Entity type:Organization
Organization Name:UROLOGY ASSOCIATES OF GREEN BAY, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / UROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:920-433-9400
Mailing Address - Street 1:1385 W MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-9366
Mailing Address - Country:US
Mailing Address - Phone:920-433-9400
Mailing Address - Fax:920-455-9409
Practice Address - Street 1:1385 W MAIN AVE
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-9366
Practice Address - Country:US
Practice Address - Phone:920-433-9400
Practice Address - Fax:920-455-9409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI21277800Medicaid
WI21277800Medicaid
WI=========012OtherBLUE CROSS WI CLINIC #