Southern Urology LLC

NPI #1407564263 in Crowley, Louisiana

Provider Information

NPI Number: 1407564263
Entity Type: Organization
Organization Name: Southern Urology LLC
Subpart: Yes (part of a larger organization)
Parent Organization: SOUTHERN UROLOGY LLC
Primary Specialty: Urology
Enumeration Date: Nov 10, 2022
Last Updated: Nov 10, 2022

Practice Location

Address: 1307 CROWLEY RAYNE HWY
City: Crowley
State: Louisiana
ZIP Code: 70526-8210
Phone: (337) 232-4555

Authorized Official

Name: MARK ROBERT ELDREDGE
Title: AUTHORIZED OFFICIAL
Phone: (337) 769-7779

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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