Provider Demographics
NPI:1871717744
Name:UROLOGY CLINIC PA
Entity type:Organization
Organization Name:UROLOGY CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SENF
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:662-284-9888
Mailing Address - Street 1:703 ALCORN DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-9302
Mailing Address - Country:US
Mailing Address - Phone:662-284-9888
Mailing Address - Fax:662-284-9899
Practice Address - Street 1:703 ALCORN DR
Practice Address - Street 2:SUITE 107
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-9302
Practice Address - Country:US
Practice Address - Phone:662-284-9888
Practice Address - Fax:662-284-9899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16367208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty