Provider Demographics
NPI:1902652779
Name:AFFILIATED UROLOGY CALL LLC
Entity type:Organization
Organization Name:AFFILIATED UROLOGY CALL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-687-0446
Mailing Address - Street 1:5133 N CENTRAL AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1438
Mailing Address - Country:US
Mailing Address - Phone:602-264-0608
Mailing Address - Fax:602-283-3048
Practice Address - Street 1:5133 N CENTRAL AVE STE 206
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1438
Practice Address - Country:US
Practice Address - Phone:602-264-0608
Practice Address - Fax:602-283-3048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty