East Georgia Urologic Clinic, PC

NPI #1801078381 in Statesboro, Georgia

Provider Information

NPI Number
1801078381
Entity Type
Organization
Organization Name
East Georgia Urologic Clinic, PC
Primary Specialty
Urology
Enumeration Date
Nov 27, 2007
Last Updated
Jan 3, 2008

Practice Location

Address
614 E GRADY ST
State
Georgia
ZIP Code
30458-2067
Phone
(912) 764-9001

Authorized Official

Name
DR. TIMOTHY R THALLER, M.D.
Title
PRESIDENT
Phone
(912) 764-9001

Specialties & Taxonomy Codes

Specialty
Urology

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