Provider Demographics
NPI:1053517862
Name:THE UROLOGY CLINIC LTD
Entity type:Organization
Organization Name:THE UROLOGY CLINIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-974-3621
Mailing Address - Street 1:6114 N NAUNI VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-5162
Mailing Address - Country:US
Mailing Address - Phone:623-974-3621
Mailing Address - Fax:480-596-6860
Practice Address - Street 1:10503 W THUNDERBIRD BLVD
Practice Address - Street 2:SUITE 317
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351
Practice Address - Country:US
Practice Address - Phone:623-974-3621
Practice Address - Fax:480-596-6860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ05046261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ3C0001208Medicare ID - Type Unspecified