Laurel Urology Clinic PA

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

05031 Issued in MS

Legal business name

LAUREL UROLOGY CLINIC PA

Practice address

304 S 10TH Ave
Laurel, MS 39440

Phone

(601) 428-0438

Fax

(601) 425-5553

NPI assigned

Jul 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Horace C Watkins III, MD

Title

President

Phone

(601) 428-0438

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin H Bond, MD

  • Urology Physician
  • Columbus, MS
  • NPI 1841290392
  NPD (past)
• Jens Francis Graversen, M.D.

  • Urology Physician
  • Laurel, MS
  • NPI 1932233392
  NPD (past)
• Robert William Santa-Cruz, M.D.

  • Urology Physician
  • Palm Harbor, FL
  • NPI 1508816869
  NPD (past)

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1669672143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2728",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394422728",
            "telephone_number": "601-428-0438",
            "fax_number": "601-425-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S 10TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "39440",
            "telephone_number": "601-428-0438",
            "fax_number": "601-425-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL UROLOGY CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "WATKINS III",
        "authorized_official_first_name": "HORACE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-428-0438",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "MS",
            "license": "05031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09011830",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurel Pharmacy, LLC
• Laurel Plastic Surgery LLC
• Laurel Speech, Language and Hearing Ctr
• Laurel Surgery & Endoscopy Center, LLC (Laurel Surgery & Endo Anesthesia)
• Laurel Surgery & Endoscopy Center, LLC
• Caitlin Lei Foong Lean
• Jeffrey Stuart Leblanc, D.D.S.
• Legendary Orthodontics, LLC
• Kent B Leggett, D.M.D.
• Laura B Lewis, RN

• Urology Physician in Laurel, MS
• Providers in Laurel, MS by specialty
• Urology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.