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
602 SAINT LANDRY ST, LAFAYETTE, LA 70506-4628
(337) 235-1200
Mailing address
602 SAINT LANDRY ST, LAFAYETTE, LA 70506-4628
(337) 235-1200
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
11/10/2022
Last updated
03/13/2023
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