NPIMap

Organization Active NPI

Southern Urology Associates LLC

  • Urology Physician
  • Gulfport, MS
National Provider Identifier
1962557157
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
SOUTHERN UROLOGY ASSOCIATES LLC
Practice address
12330 Ashley Dr
Gulfport, MS 39503-2737
Phone
(228) 831-1572
Fax
(228) 831-1218
NPI assigned
Jan 25, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert J. Lageese
Title
Vice President
Phone
(504) 988-7044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

12330 Ashley Dr
Gulfport, MS 39503-2737

Mailing address

12330 Ashley Dr
Gulfport, MS 39503-2737
Phone (228) 831-1572

National Provider Directory

National Provider Directory
Tax ID family
Southern Urology Assoc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962557157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12330 ASHLEY DR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032737",
            "telephone_number": "228-831-1572",
            "fax_number": "228-831-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12330 ASHLEY DR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032737",
            "telephone_number": "228-831-1572",
            "fax_number": "228-831-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN UROLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAGEESE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "504-988-7044"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.