GEORGIA UROLOGY PA
NPI 1417172602
Urology in Duluth, GA
NPI Status: Active since April 15, 2007
Contact Information
3790 PLEASANT HILL RD
SUITE 150
DULUTH, GA
ZIP 30096
Phone: (770) 979-9427
Fax: (770) 972-3846
- Organization
- Urology
- CLIA Number: 11D0890208
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-22-2026
About GEORGIA UROLOGY PA
This page provides the complete NPI Profile along with additional information for Georgia Urology Pa, a provider established in Duluth, Georgia operating as a Urology. The healthcare provider is registered in the NPI registry with number 1417172602 assigned on April 2007. The practitioner's primary taxonomy code is 208800000X. The provider is registered as an organization and their NPI record was last updated May 2025. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Mark A Haber M.d. (Managing Partner)
- NPI
- 1417172602
- Provider Name
- GEORGIA UROLOGY PA
- Entity Type
- Organization
- Location Address
- 3790 PLEASANT HILL RD SUITE 150 DULUTH, GA 30096
- Location Phone
- (770) 979-9427
- Location Fax
- (770) 972-3846
- Mailing Address
- 1930 BRANNAN RD MCDONOUGH, GA 30253
- Mailing Phone
- (678) 284-4040
- Mailing Fax
- (770) 972-3846
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 04-15-2007
- Last Update Date
- 05-13-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Urology
- Taxonomy Code
- 208800000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D0890208
- Facility Type
- Physician Office
- Certificate Effective Date
- October 23, 2024
- Certificate Expiration Date
- October 22, 2026
- Laboratory Director
- DR. RONALD ANGLADE
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Georgia Urology Pa in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 1 | 7 | 1 | 7 | 2 | 6 | 0 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 2 | 7 | 2 | 7 | 4 | 6 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 2 + 7 + 2 + 7 + 4 + 6 + 0 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1417172602 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1023225190 | LI ZUO MD Individual | Allergy & Immunology | 3790 PLEASANT HILL RD SUITE 200 DULUTH, GA 30096 (678) 837-5224 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417172602, enumerated in the NPI registry as an "organization" on April 15, 2007
The provider is located at 3790 Pleasant Hill Rd Suite 150 Duluth, Ga 30096 and the phone number is (770) 979-9427
This medical organization specializes in Urology with taxonomy code 208800000X
The provider's CLIA number is 11D0890208 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on April 15, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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