GEORGIA UROLOGY PA (NPI# 1508081795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508081795 |
| Entity Type | Organization |
| Organization Name | GEORGIA UROLOGY PA |
| Practice Address |
4645 Timber Ridge Dr Ste 120 Douglasville GA 30135-7542 |
| Mailing Address |
1930 Brannan Rd Mcdonough GA 30253-4310 |
| Practice Telephone | 7709422478 |
| Practice Fax Number | 6786314986 |
| Mailing Telephone | 6782844040 |
| Mailing Fax Number | 6782844076 |
| Enumeration Date | 2007-04-15 |
| Last Update Date | 2020-11-04 |
| Authorized Official Name | DR. 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | CLIA | 11D0980072 | 01 |
| 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 |
| 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 |
| 1851826036 | Georgia Urology Pa | Urology | 675 White Sulphur Rd, Suite 180, Gainesville, GA 30501-8921 | 2017-04-26 |
| Street Address |
4645 TIMBER RIDGE DR STE 120 |
| City | DOUGLASVILLE |
| State | GA |
| Zip Code | 30135-7542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265043301 | Heart & Soul Wellness Solutions LLC | Social Worker | 4752 Pepper Tree Lane, Douglasville, GA 30135 | 2020-08-12 |
| 1477176923 | R & J Health Care | Clinic/Center | 6853b Douglas Blvd Ste B, Douglasville, GA 30135 | 2020-05-19 |
| 1003479411 | The Sister Circle of Love and Empowerment LLC | Clinic/Center | 4706 Boyer Glen Dr., Douglasville, GA 30135 | 2019-04-22 |
| 1457825358 | Marcia Ann-marie Wilson | Nurse Practitioner | 4279 Caroline Court, Douglasville, GA 30135 | 2019-01-14 |
| 1225564917 | Danielle Doebereiner-brown | Nurse Practitioner | 3872 Ga-5, Douglasville, GA 30135 | 2017-05-02 |
| 1851832430 | Jennifer Williams | Physical Therapist | 4999 Presley Mill Rd, Douglasville, GA 30135 | 2017-03-15 |
| 1316484686 | Geneva Brent | Licensed Practical Nurse | 2109 Fairburn Road, Douglasville, GA 30135 | 2017-01-25 |
| 1659816288 | Stephanie Walthour | Marriage & Family Therapist | 3400 Chapel Hill Rd Ste 317, Douglasville, GA 30135 | 2017-01-05 |
| 1770932105 | Solutions 2 Wellness and Recovery,llc | Social Worker | 2256 Greenwood Meadows Lane, Douglasville, GA 30135 | 2016-06-07 |
| 1326408378 | Sr & L Transport Services, LLC | Non-emergency Medical Transport (VAN) | 4841 Black Bear Trail, Douglasville, GA 30135 | 2016-03-03 |
| Find all providers in zip 30135 | ||||
| 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 |
|---|---|---|---|---|
| 1831333046 | Odinaka John Akunne | Urology | 6002 Professional Pkwy Ste 280, Douglasville, GA 30134-5627 | 2009-05-01 |
| 1851340871 | Urology Clinic Northwest, PC | Urology | 8954 Hospital Dr, Suite 115d, Douglasville, GA 30134-2272 | 2006-05-08 |
| 1740239730 | George G Mygatt | Urology | 6002 Professional Pkwy, Suite 280, Douglasville, GA 30134-5600 | 2006-05-08 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | DOUGLASVILLE |
| Zip Code | 30135 |
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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.