NPIMap

Organization Active NPI

Serge P Marinkovic MD Female Reconstructive Surgery LLC

  • Urology Physician
  • Lafayette, LA
National Provider Identifier
1871782581
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD.200543 Issued in LA
Legal business name
SERGE P MARINKOVIC MD FEMALE RECONSTRUCTIVE SURGERY LLC
Doing business as
SPM FEMALE RECONSTRUCTIVE SURGERY
Practice address
4540 Ambassador Caffery Pkwy
Suite A220
Lafayette, LA 70508-6928
Phone
(337) 504-2671
Fax
(337) 504-2673
NPI assigned
Oct 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Dr. Serge P Marinkovic, MD
Title
President
Phone
(337) 504-2671

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X MD.200543 LA
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X MD.200543 LA
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X MD.200543 LA Primary

Addresses

Primary practice location

4540 Ambassador Caffery Pkwy
Suite A220
Lafayette, LA 70508-6928

Mailing address

4540 Ambassador Caffery Pkwy
Suite A220
Lafayette, LA 70508-6928
Phone (337) 504-2671

Other names 1

  • SPM FEMALE RECONSTRUCTIVE SURGERY Doing business as

National Provider Directory

National Provider Directory

Locations

4540 Ambassador Caffery Pkwy
Ste A220
Lafayette, LA 70508
Phone (337) 504-2671

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1871782581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 AMBASSADOR CAFFERY PKWY",
            "address_2": "SUITE A220",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086928",
            "telephone_number": "337-504-2671",
            "fax_number": "337-504-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 AMBASSADOR CAFFERY PKWY",
            "address_2": "SUITE A220",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086928",
            "telephone_number": "337-504-2671",
            "fax_number": "337-504-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGE P MARINKOVIC MD FEMALE RECONSTRUCTIVE SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MARINKOVIC",
        "authorized_official_first_name": "SERGE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-504-2671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "LA",
            "license": "MD.200543",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "LA",
            "license": "MD.200543",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "LA",
            "license": "MD.200543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPM FEMALE RECONSTRUCTIVE SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 21, 2018; 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.