NPI 1821082124

Larry Hugh Formby, MD

Practitioner Urology Physician Rome, GA

Practice location

Address: 1013 N 5th Ave NE STE One, Rome, GA 30165-2664
Phone: (706) 295-2393
Fax: (706) 290-1101

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 19043 (GA)

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Registry record

NPI: 1821082124
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Sep 2005
Record last updated: 23 Nov 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.