DR. HARCOURT BRENT MUNDY (NPI# 1528029386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528029386 |
| Entity Type | Individual |
| Full Name | DR. HARCOURT BRENT MUNDY |
| Credential | MD |
| Practice Address |
523 Dixie St Suite 3 Carrollton GA 30117 |
| Mailing Address |
106 Dunes Ct Carrollton GA 30116-6077 |
| Practice Telephone | 7708308944 |
| Practice Fax Number | 7708385831 |
| Mailing Telephone | 4043143440 |
| Mailing Fax Number | 7708385831 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2008-06-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 024468 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICAID REFERENCE NUMBER | REF000021759 | 01 |
| GA | 000256891A | 05 |
| Street Address |
523 DIXIE ST SUITE 3 |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871127399 | Tammy Patterson | Registered Nurse | 523 Dixie St, Carrollton, GA 30117-3870 | 2020-02-24 |
| 1003449273 | Kiera Rhodes | Counselor | 523 Dixie St, Carrollton, GA 30117-3870 | 2020-02-17 |
| 1801428545 | Makenzie Smith | Counselor | 523 Dixie St, Carrollton, GA 30117-3870 | 2020-02-11 |
| 1831721802 | Amanda Robinson | Counselor | 523 Dixie St, Carrollton, GA 30117-3870 | 2020-02-07 |
| 1235779778 | Vanisha Patel | Counselor | 523 Dixie St, Carrollton, GA 30117-3870 | 2020-01-13 |
| 1982241683 | Tenecia Latonya Allen | Case Manager/Care Coordinator | 523 Dixie St, Carrollton, GA 30117-3870 | 2019-12-02 |
| 1275170979 | Samantha Amanda Adams | Counselor | 523 Dixie St, Carrollton, GA 30117-3870 | 2019-12-02 |
| 1467098335 | Anne Joe Ryan | Counselor | 523 Dixie St, Carrollton, GA 30117-3870 | 2019-11-26 |
| 1255977252 | Angela Lester | Social Worker | 523 Dixie St, Carrollton, GA 30117-3870 | 2019-11-25 |
| 1720624729 | Rebekah Hope Ridley | Behavior Technician | 523 Dixie St, Carrollton, GA 30117-3870 | 2019-11-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| Find all providers in zip 30117 | ||||
| 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 |
|---|---|---|---|---|
| 1922597517 | Wguasc, LLC | Urology | 150 Clinic Ave Ste 203, Carrollton, GA 30117-4402 | 2018-05-09 |
| 1528054046 | Ali R Shirvani | Urology | 4325 N Josey Ln Ste 206, Carrollton, TX 75010-4637 | 2005-09-20 |
| 1275929184 | Wguas, LLC | Urology | 150 Clinic Ave, Suite 202, Carrollton, GA 30117-4401 | 2015-04-08 |
| 1639368285 | Ralph J. Posch, M.d., F.a.c.s., P.a. | Urology | 4333 N Josey Ln, Suite 205, Carrollton, TX 75010-4629 | 2007-10-19 |
| 1003010893 | Andrea S Hatchette | Urology | 4333 N Josey Ln Ste 104, Carrollton, TX 75010-4620 | 2007-06-13 |
| 1982701124 | West Georgia Urology Associates PC | Urology | 150 Clinic Ave, Suite 202, Carrollton, GA 30117-4402 | 2006-09-20 |
| 1194787408 | James Wesley Cullison | Urology | 150 Clinic Ave, Suite 202, Carrollton, GA 30117-4401 | 2006-04-03 |
| 1881656288 | Kevin Patrick Mclaughlin | Urology | 150 Clinic Ave, Suite 202, Carrollton, GA 30117-4401 | 2006-04-03 |
| 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 |
| 1841788395 | Houston Physician Specialists, LLC | Urology | 233 N Houston Rd Ste 100, Warner Robins, GA 31093-8944 | 2018-04-30 |
| 1457851255 | Advanced Urology Institute of Georgia | Urology | 501 Crown Point Way, Lawrenceville, GA 30046 | 2018-02-19 |
| Find all providers with the same taxonomy | ||||
| City | CARROLLTON |
| Zip Code | 30117 |
Please comment or provide details below to improve the information on DR. HARCOURT BRENT MUNDY.
| 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.