Provider Demographics
NPI:1831420199
Name:TUSCARAWAS VALLEY UROLOGY, LTD
Entity type:Organization
Organization Name:TUSCARAWAS VALLEY UROLOGY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRYSTAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-364-7830
Mailing Address - Street 1:300 MEDICAL PARK DRIVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622
Mailing Address - Country:US
Mailing Address - Phone:330-364-7830
Mailing Address - Fax:330-364-7802
Practice Address - Street 1:300 MEDICAL PARK DRIVE
Practice Address - Street 2:SUITE 103
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622
Practice Address - Country:US
Practice Address - Phone:330-364-7830
Practice Address - Fax:330-364-7802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty