Provider Demographics
NPI:1871744862
Name:ST GEORGE UROLOGY LLC
Entity type:Organization
Organization Name:ST GEORGE UROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:COPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-688-2104
Mailing Address - Street 1:1490 E FOREMASTER DR
Mailing Address - Street 2:300
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-4488
Mailing Address - Country:US
Mailing Address - Phone:435-688-2104
Mailing Address - Fax:435-628-5308
Practice Address - Street 1:1490 E FOREMASTER DR
Practice Address - Street 2:300
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4488
Practice Address - Country:US
Practice Address - Phone:435-688-2104
Practice Address - Fax:435-628-5308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty