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EAST GEORGIA UROLOGIC CLINIC, PC
NPI 1801078381
Urology in Statesboro, GA

Active since November 27, 2007CLIA 11D1073777 · Microscopy
614 E GRADY ST, STATESBORO, GA 30458(912) 764-9001(912) 764-3166 Get Directions Write a Review

NPPES record last updated: January 3, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About East Georgia Urologic Clinic, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAST GEORGIA UROLOGIC CLINIC, PC (NPI 1801078381) is a healthcare organization registered as an urology in Statesboro, Georgia and active in the NPI registry since November 2007. The organization holds a CLIA Microscopy certificate valid through July 22, 2027 and lists Timothy R Thaller, President, as its authorized official.

NPPES Registry Identity

NPI1801078381
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameEAST GEORGIA UROLOGIC CLINIC, PC
Location Address614 E GRADY STStatesboro, GA 30458-2067
Mailing Address614 East Grady StreetStatesboro, GA 30458 · (912) 764-9001 · Fax (912) 764-3166
Phone(912) 764-9001
Fax(912) 764-3166
Organization SubpartNo
Authorized OfficialTimothy R ThallerPresident · (912) 764-9001
Enumeration DateNovember 27, 2007
Last NPPES UpdateJanuary 3, 2008
✔ NPI 1801078381 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License✔ Licensed in GA · 046818
Definition
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.
614 E GRADY ST, Statesboro, GA 30458
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 11D1073777

East Georgia Urology · Statesboro, GA
Active · expires Jul 22, 2027
CLIA Number11D1073777
Laboratory TypePhysician Office
Certificate Effective DateJuly 23, 2025
Certificate Expiration DateJuly 22, 2027
Laboratory DirectorDr. Timothy Thaller
Laboratory Phone(912) 764-9001
Laboratory LocationEast Georgia Urology1497 Fair Road, Suite 102, Statesboro, GA 30458
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Georgia Urologic Clinic, PC's NPI number?

The NPI number for East Georgia Urologic Clinic, PC is 1801078381. It was assigned to this organization in the NPPES registry on November 27, 2007.

Where is East Georgia Urologic Clinic, PC located?

East Georgia Urologic Clinic, PC is located at 614 E Grady St, Statesboro, GA 30458. The listed phone number is (912) 764-9001.

What is East Georgia Urologic Clinic, PC's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Does East Georgia Urologic Clinic, PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 11D1073777) is associated with this NPI, valid through July 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for East Georgia Urologic Clinic, PC was last updated on January 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.