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 (AUTHORIZED OFFICIAL)
(337) 769-7779
Entity
Organization
Contact information
Practice address
1307 CROWLEY RAYNE HWY, CROWLEY, LA 70526-8210
(337) 232-4555
Mailing address
1307 CROWLEY RAYNE HWY, CROWLEY, LA 70526-8210
(337) 232-4555
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
11/10/2022
Last updated
11/10/2022
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