Organization
CENLA UROLOGY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE FAYE EDENS (PRACTICE MANAGER)
(318) 442-3384
Entity
Organization
Contact information
Practice address
3311 PRESCOTT RD STE 100, ALEXANDRIA, LA 71301-3917
(318) 442-3384
(318) 442-3385
Mailing address
3311 PRESCOTT RD, SUITE 100, ALEXANDRIA, LA 71301-3900
(318) 442-3384
(318) 442-3385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
L009778
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1792101
—
LA
Enumeration date
04/17/2007
Last updated
06/04/2022
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