Southern Urology LLC
Urology in Lafayette, LA. Organization (NPI-2).
NPI number1760612865
StatusActive
Last updated in NPPESJan 4, 2010
Details
- NPI
- 1760612865
- Entity type
- Organization (NPI-2)
- Legal business name
- Southern Urology LLC
- Organization subpart
- No
- Enumeration date
- Jul 23, 2009
- Last updated
- Jan 4, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | – | – | Yes |
Other names
- Coolidge Location (Other Name)
Practice location
1016 Coolidge BlvdLafayette, LA 70503-2436
Phone 337-233-6665 · Fax 337-233-0327
Mailing address
Po Box 54028Lafayette, LA 70505-4028
Phone 337-233-6665 · Fax 337-233-0327
Authorized official
Edward F Breaux
Managing Member
3372336665
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