Organization
SOUTHERN UROLOGY LLC
Active
Parent organization
SOUTHERN UROLOGY LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN UROLOGY LLC
Authorized official
MARK ROBERT ELDREDGE (AO)
(337) 769-7779
Entity
Organization
Contact information
Practice address
2308 E MAIN ST STE A, NEW IBERIA, LA 70560-4029
(337) 408-8676
Mailing address
2308 E MAIN ST STE A, NEW IBERIA, LA 70560-4029
(337) 408-8676
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
11/10/2022
Last updated
04/02/2024
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