NPIMap

Organization Active NPI

Southern Urology LLC

  • Urology Physician
  • Crowley, LA
National Provider Identifier
1407564263
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
SOUTHERN UROLOGY LLC
Practice address
1307 Crowley Rayne Hwy
Crowley, LA 70526-8210
Phone
(337) 232-4555
NPI assigned
Nov 10, 2022
Organization subpart
Yes
Parent organization
SOUTHERN UROLOGY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark Robert Eldredge
Title
Authorized Official
Phone
(337) 769-7779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

1307 Crowley Rayne Hwy
Crowley, LA 70526-8210

Mailing address

1307 Crowley Rayne Hwy
Crowley, LA 70526-8210
Phone (337) 232-4555

National Provider Directory

National Provider Directory
Tax ID family
Southern Urology LLC5 organizations share this tax ID, including this one
Part of
Southern Urology LLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1407564263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 CROWLEY RAYNE HWY",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705268210",
            "telephone_number": "337-232-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 CROWLEY RAYNE HWY",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705268210",
            "telephone_number": "337-232-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN UROLOGY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN UROLOGY LLC",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "ELDREDGE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "337-769-7779"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crowley, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.