Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

East Georgia Urologic Clinic, PC

Organization Urology Physician · NPI 1801078381

East Georgia Urologic Clinic, PC is an Urology Physician in Statesboro, Georgia. Licensed in Georgia. Registered with an NPI since 2007.

Licensed in
GA
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

614 E Grady St
Statesboro, GA 30458-2067
Phone: (912) 764-9001
Fax: (912) 764-3166
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 046818 (GA)

Record details

NPI number1801078381
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Thaller — President · (912) 764-9001
NPI enumeratedNovember 27, 2007
Last updated in NPPESJanuary 3, 2008
Mailing address614 East Grady Street, Statesboro, GA 30458

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