NPIMap

Organization Active NPI

Southern Urology LLC

  • Urology Physician
  • Lafayette, LA
National Provider Identifier
1467160234
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
SOUTHERN UROLOGY LLC
Practice address
602 Saint Landry St
Lafayette, LA 70506-4628
Phone
(337) 235-1200
NPI assigned
Nov 10, 2022
Organization subpart
Yes
Parent organization
SOUTHERN UROLOGY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

602 Saint Landry St
Lafayette, LA 70506-4628

Mailing address

602 Saint Landry St
Lafayette, LA 70506-4628
Phone (337) 235-1200

National Provider Directory

National Provider Directory
Part of
Southern Urology LLC

Locations

602 Saint Landry St
Lafayette, LA 70506
Phone (337) 235-1200

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": "1678665600000",
    "number": "1467160234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 SAINT LANDRY ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064628",
            "telephone_number": "337-235-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 SAINT LANDRY ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064628",
            "telephone_number": "337-235-1200"
        }
    ],
    "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": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "ELDREDGE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "AO",
        "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 Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.