Urology Clinic of Northeast Louisiana - a Medical Corporation

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

UROLOGY CLINIC OF NORTHEAST LOUISIANA - A MEDICAL CORPORATION

Doing business as

Urology Clinic

Practice address

711 Saint John Street
Monroe, LA 71201-8435

Phone

(318) 387-9420

Fax

(318) 323-8216

NPI assigned

Jun 24, 2006

Organization subpart

No

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

Authorized official

Name

Jon Bradley Johnson, MD

Title

Physician Owner

Phone

(318) 387-9420

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Urology Clinic Doing business as

Locations

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1760418396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 SAINT JOHN STREET",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712018435",
            "telephone_number": "318-387-9420",
            "fax_number": "318-323-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 SAINT JOHN STREET",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712018435",
            "telephone_number": "318-387-9420",
            "fax_number": "318-323-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY CLINIC OF NORTHEAST LOUISIANA - A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "318-387-9420",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "LA",
            "license": "013314",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1106607",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Urology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• University of Louisiana of Monroe
• Dipesh Upreti, M.D.
• Subodh Bhakta Uprety, MD
• Urban Drug Store Inc
• Urban Medical Clinic, Inc.
• Gowrish Vaka
• Christian Antonio Valle, DPM
• Van & Company LLC
• Peggy G. Van, R.PH.
• Lisa Delores Vanhoose, PHD, MPH, PT

• Urology Physician in Monroe, LA
• Providers in Monroe, LA by specialty
• Urology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.