GEORGIA UROLOGY PA (NPI# 1417297391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417297391 |
| Entity Type | Organization |
| Organization Name | GEORGIA UROLOGY PA |
| Practice Address |
1100 Northside Forsyth Dr Suite 410 Cumming GA 30041-6012 |
| Mailing Address |
1930 Brannan Rd Mcdonough GA 30253-4310 |
| Practice Telephone | 6789476199 |
| Practice Fax Number | 6789476641 |
| Mailing Telephone | 6782844040 |
| Mailing Fax Number | 6782844076 |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2015-01-28 |
| Authorized Official Name | MARK A HABER (MANAGING PARTNER) |
| Authorized Official Telephone | 6782844049 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA UROLOGY PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265995724 | Georgia Urology Pa | Non-Pharmacy Dispensing Site | 5900 Hillandale Dr Ste 200, Lithonia, GA 30058-3858 | 2019-04-11 |
| 1447772348 | Georgia Urology Pa | Urology | 4800 Olde Towne Pkwy Ste 220, Marietta, GA 30068-4391 | 2017-07-12 |
| 1154855740 | Georgia Urology Pa | Urology | 2161 W Spring St., Suite C, Monroe, GA 30655-3196 | 2017-04-20 |
| 1720510241 | Georgia Urology Pa | Urology | 1110 W Peachtree St Nw Ste 1020, Atlanta, GA 30309-3609 | 2017-04-03 |
| 1184089989 | Georgia Urology Pa | Urology | 2151b West Spring St, Ste 210, Monroe, GA 30655-3115 | 2015-12-21 |
| 1528308988 | Georgia Urology Pa | Urology | 1357 Hembree Rd Ste 250, Roswell, GA 30076-5724 | 2013-02-21 |
| 1821261744 | Georgia Urology Pa | Urology | 200 Dawson Commons Circle, Dawsonville, GA 30534 | 2008-04-11 |
| 1508081795 | Georgia Urology Pa | Urology | 4645 Timber Ridge Dr Ste 120, Douglasville, GA 30135-7542 | 2007-04-15 |
| 1871144246 | Georgia Urology Pa | Urology | 1670 Scott Blvd Ste 204k, Decatur, GA 30033-5645 | 2019-09-26 |
| 1073028643 | Georgia Urology Pa | Urology | 4150 Deputy Bill Cantrell Memorial Road, Suite 140b, Cumming, GA 30040 | 2017-12-05 |
| Street Address |
1100 NORTHSIDE FORSYTH DR SUITE 410 |
| City | CUMMING |
| State | GA |
| Zip Code | 30041-6012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003814716 | John P Gorecki | Neurological Surgery | 1100 Northside Forsyth Dr, Suite 310, Cumming, GA 30041-6012 | 2005-07-07 |
| 1790221273 | James Quick | Pharmacist | 1100 Northside Forsyth Dr, Cumming, GA 30041-6012 | 2017-01-09 |
| 1417402108 | Kanitha K Sar | Nurse Practitioner | 1100 Northside Forsyth Dr, Suite 210, Cumming, GA 30041-6012 | 2016-08-23 |
| 1558712513 | Stephanie Upchurch | Specialist/Technologist, Other | 1100 Northside Forsyth Dr, 420, Cumming, GA 30041-6012 | 2016-06-30 |
| 1407205859 | Sydnie Christine Freeman | Audiologist | 1100 Northside Forsyth Dr, Ste 490, Cumming, GA 30041-6012 | 2016-06-07 |
| 1184070740 | Jacob Summerford | Physician Assistant | 1100 Northside Forsyth Dr, Suite 250, Cumming, GA 30041-6012 | 2016-05-12 |
| 1720459621 | Kellie Cain Henderson | Nurse Practitioner | 1100 Northside Forsyth Dr, Suite 330, Cumming, GA 30041-6012 | 2015-10-18 |
| 1194194548 | Neurosurgery Answer, LLC | Neurological Surgery | 1100 Northside Forsyth Dr, Suite 310, Cumming, GA 30041-6012 | 2015-09-16 |
| 1962806596 | Pretesh Parmar | Physician Assistant | 1100 Northside Forsyth Dr, Suite 340, Cumming, GA 30041-6012 | 2014-10-10 |
| 1205248382 | Tsz Yan Julitta Lam | Physical Therapist | 1100 Northside Forsyth Dr, Suite 340, Cumming, GA 30041-6012 | 2014-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962036905 | Annie Kyungjin Han | Nurse Practitioner | 1505 Northside Forsyth Drive, Suite 2500, Cumming, GA 30041 | 2020-02-28 |
| 1295388197 | Pamela Edler | Pharmacist | 1200 Northside Forsyth Drive, Pharmacy Department, Cumming, GA 30041 | 2019-07-19 |
| 1720557127 | Dr. Tiffany Lamonde LLC | Physical Therapist | 1445 Haw Creek Circle, Suite 503, Cumming, GA 30041 | 2018-11-15 |
| 1487140893 | Bhbd LLC | Chiropractor | 425 Peachtree Parkway, Suite 315, Cumming, GA 30041 | 2018-07-09 |
| 1891219861 | Anna Gawrys | Pharmacist | 1525 Marketplace Blvd, Cumming, GA 30041 | 2017-08-01 |
| 1679029219 | Square One Dental LLC | Clinic/Center | 3510 Rowe Lane, Cumming, GA 30041 | 2016-09-01 |
| 1720441454 | Pavilion Psychological Services LLC | Psychologist | 1445 Haw Creek Corners Circle East, Suite 501, Cumming, GA 30041 | 2016-03-31 |
| 1346606506 | American Health Imaging of Ga, LLC | Clinic/Center | 1050 Haw Creek Pkwy, Suite 100, Cumming, GA 30041 | 2016-01-04 |
| 1013311307 | Stephen Hartle | Physician Assistant | 2576 Peachtree Pkwy, Suite 100, Cumming, GA 30041 | 2014-10-15 |
| 1063828408 | Stephanie Evans Wellborn | Physician Assistant | 1800 Northside Forsyth Dr Ste 450, Cumming, GA 30041 | 2014-07-07 |
| Find all providers in zip 30041 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003428590 | Georgia Urology, Pa | Urology | 4150 Deputy Bill Cantrell Memorial Rd., Suite 140a, Cumming, GA 30040 | 2020-08-18 |
| 1700407772 | Advanced Urology Institute of Georgia, PC | Urology | 3075 Ronald Reagan Blvd Ste 501, Cumming, GA 30041-6052 | 2020-04-30 |
| 1073028643 | Georgia Urology Pa | Urology | 4150 Deputy Bill Cantrell Memorial Road, Suite 140b, Cumming, GA 30040 | 2017-12-05 |
| 1972728160 | Georgia Urology Pa | Urology | 1800 Northside Forsyth Dr, Suite 370, Cumming, GA 30041-8447 | 2007-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820576 | Advanced Urology Institute of Georgia PC | Urology | 2205 Riverstone Blvd Ste 101, Canton, GA 30114-5250 | 2020-04-23 |
| 1093369795 | Georgia Urology, Pa | Urology | 470 Northside Cherokee Blvd Ste 210, Canton, GA 30115-8029 | 2019-07-31 |
| 1790248953 | Michael Oberle | Urology | 1120 15th St Rm Baa 8415, Augusta, GA 30912-4050 | 2019-04-12 |
| 1598220915 | Effingham Urology, LLC | Urology | 613 Towne Park Dr W Ste 204, Rincon, GA 31326-5183 | 2019-02-11 |
| 1275008351 | Center for Special Surgery LLC | Urology | 11660 Alpharetta Hwy Ste 720, Roswell, GA 30076-4916 | 2018-10-04 |
| 1295200426 | Paul Edward Henson Jr. | Urology | 1837 Wood Valley Dr, Dalton, GA 30720-3846 | 2018-10-03 |
| 1477033124 | Urological Health Center, PC | Urology | 1770 Watson Boulevard, Warner Robins, GA 31093 | 2018-08-21 |
| 1982182655 | Advanced Urology Institute of Georgia | Urology | 1460 S Johnson Ferry Rd, Atlanta, GA 30319-4301 | 2018-08-03 |
| 1922597517 | Wguasc, LLC | Urology | 150 Clinic Ave Ste 203, Carrollton, GA 30117-4402 | 2018-05-09 |
| 1841788395 | Houston Physician Specialists, LLC | Urology | 233 N Houston Rd Ste 100, Warner Robins, GA 31093-8944 | 2018-04-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.