GAINESVILLE UROLOGY CENTER PA (NPI# 1750487872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750487872 |
| Entity Type | Organization |
| Organization Name | GAINESVILLE UROLOGY CENTER PA |
| Practice Address |
4881 Nw 8th Ave Suite 2 Gainesville FL 32605-4582 |
| Practice Telephone | 3523736338 |
| Practice Fax Number | 3523736144 |
| Mailing Telephone | 3523736338 |
| Mailing Fax Number | 3523736144 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. CLARK DALE GADDY (PRESIDENT) |
| Authorized Official Telephone | 3523736338 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | ME0048155 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS FL GROUP NUMBER | 43583 | 01 |
| Street Address |
4881 NW 8TH AVE SUITE 2 |
| City | GAINESVILLE |
| State | FL |
| Zip Code | 32605-4582 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336125848 | Bernard Bryan Bulcourf | Psychologist | 4881 Nw 8th Ave, Suite 2, Gainesville, FL 32605-4582 | 2005-12-16 |
| 1093970162 | Southeastern Integrated Medical Pl | Counselor | 4881 Nw 8th Ave, Suite 2, Gainesville, FL 32605-4582 | 2008-07-28 |
| 1992870380 | John Anthony Bailey | Anesthesiology | 4881 Nw 8th Ave, Ste 2, Gainesville, FL 32605-4582 | 2006-11-21 |
| 1144275918 | Lu Anne Faubion | Nurse Practitioner | 4881 Nw 8th Ave, Suite 2, Gainesville, FL 32605-4582 | 2006-05-23 |
| 1992784284 | Jesse August Lipnick | Pain Medicine | 4881 Nw 8th Ave, Suite 2, Gainesville, FL 32605-4582 | 2006-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780205435 | Remy Fadel | Student in an Organized Health Care Education/Training Program | 1147 Nw 64th Terr, Gainsville, FL 32605 | 2020-05-05 |
| 1518528652 | Family Restoration Station Counseling Center, LLC | Marriage & Family Therapist | 912 Nw 56th Terr, Suite A, Gainesville, FL 32605 | 2019-06-27 |
| 1568925105 | Ryeisha Hough | Behavior Technician | 1051 Sw 56 Terrace, Gainesville, FL 32605 | 2019-04-10 |
| 1003308040 | Titan Mri LLC | Clinic/Center | 919 Nw 57th St Ste 20, Gainesville, FL 32605 | 2018-06-05 |
| 1922598432 | Angela Maria Fernandez Manovel | Student in an Organized Health Care Education/Training Program | 1147 Nw 64th Terrace, Gainesville, FL 32605 | 2018-05-10 |
| 1396235800 | Aya Marachi | Student in an Organized Health Care Education/Training Program | 6500 W. Newberry Rd., Gainesville, FL 32605 | 2018-05-10 |
| 1053813543 | Jaime L Jasser | Counselor | 2240 Nw 40th Terrace Ste A, Gainesville, FL 32605 | 2018-03-01 |
| 1164932901 | Anesthesia Physician Solutions of North Florida, LLC | Anesthesiology | 6500 W Newberry Road, Gainesville, FL 32605 | 2017-10-06 |
| 1336667930 | Zina Theresse Durr | Adult Companion | 3124 Nw 29th Place, Gainesville, FL 32605 | 2017-09-03 |
| 1982126306 | Crystal Thompson Baumann | Nurse Practitioner | 6440 W Newberry Rd Ste 409, Gainesville, FL 32605 | 2017-07-07 |
| Find all providers in zip 32605 | ||||
| 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 |
|---|---|---|---|---|
| 1386059368 | Jonathan Wirick Angelle | Urology | 1240 Jesse Jewell Pkwy Se Ste 200, Gainesville, GA 30501-3861 | 2014-06-27 |
| 1164849303 | Julia Han | Urology | 1600 Sw Archer Rd Rm N-203, Gainesville, FL 32610-0247 | 2014-03-26 |
| 1083635494 | Perinchery Narayan | Urology | 3426 Nw 43rd St, Suite B, Gainesville, FL 32606-8105 | 2006-07-21 |
| 1528084183 | Christopher Michael Cassisi | Urology | 6420 Nw 9 Blvd, Gainesville, FL 32605 | 2006-07-15 |
| 1669415667 | Sean Patrick Mclaughlin | Urology | 6420 Nw 9th Blvd, Gainesville, FL 32605-4203 | 2006-06-14 |
| 1821041476 | Brent A Sharpe | Urology | 660 Lanier Park Dr Ste A, Gainesville, GA 30501-2075 | 2006-05-17 |
| 1639128168 | Martin Neil Rifkin | Urology | 1179 Nw 64th Ter, Gainesville, FL 32605-4218 | 2006-05-10 |
| 1114926912 | Ronald Leroy Brock | Urology | 660 Lanier Park Drive, Ste A, Gainesville, GA 30501-2075 | 2005-07-14 |
| 1063419281 | William Bird Jones | Urology | 660-a Lanier Park Drive, Gainesville, GA 30501-2075 | 2005-07-01 |
| 1770104473 | Advanced Urology Institute of Georgia PC | Urology | 601 Broad St Se Ste B, Gainesville, GA 30501-3718 | 2020-05-04 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 32605 |
Please comment or provide details below to improve the information on GAINESVILLE UROLOGY CENTER PA.
| 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.