NPI age
19 years
Enumerated 2007-05-17
● Active Type 2 · Organization
Eastside Urology
Eastside Urology is 1 of 563 urology organizations in Georgia.
Primary specialty
Urology
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Vickers
Director Of Billing
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 563 active urology providers in Georgia.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-05Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
2121 Fountain Dr, Suite D
Snellville, GA 300787023
Mailing address
2121 Fountain Dr
Snellville, GA 300787023
Authorized official
Carolyn L Vickers
Director Of Billing
📞 7707368368
Individual providers at this organization
7 individual providers on file at this primary practice address.
- Kenise Gardner, RBT Behavior Technician NPI 1457127300
- Tanya High, LMT Homeopath NPI 1518150432
- Samuel Kridl, PT, DPT Physical Therapist NPI 1407289903
- Amanda Lamin Behavior Technician NPI 1609645613
- Tisha Massey, RBT Behavior Technician NPI 1699556050
- Charetta Oliver, PT, DPT Physical Therapist NPI 1518259332
- Claire Velten, PT, DPT Physical Therapist NPI 1689050908
Specialties
-
Urology PrimaryA 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...
Practice context
Multi-provider organization. 7 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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