Organization
SOUTHERN UROLOGY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J. LAGEESE (VICE PRESIDENT)
(504) 988-7044
Entity
Organization
Contact information
Practice address
12330 ASHLEY DR, GULFPORT, MS 39503-2737
(228) 831-1572
(228) 831-1218
Mailing address
12330 ASHLEY DR, GULFPORT, MS 39503-2737
(228) 831-1572
(228) 831-1218
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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