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SOUTHERN UROLOGY LLC
NPI 1104534965
Urology in New Iberia, LA

Active since November 10, 2022CLIA Certified · 2 labs
2308 E MAIN ST STE A, NEW IBERIA, LA 70560(337) 408-8676 Get Directions Write a Review

NPPES record last updated: April 2, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 2, 2024, Mar 13, 2023, Nov 21, 2022 and 1 more (4 updates tracked since 2022).

About Southern Urology Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN UROLOGY LLC (NPI 1104534965) is a healthcare organization registered as an urology in New Iberia, Louisiana and active in the NPI registry since November 2022. The organization holds 2 active CLIA laboratory certificates and lists Mark Robert Eldredge, Ao, as its authorized official.

NPPES Registry Identity

NPI1104534965
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameSOUTHERN UROLOGY LLC
Location Address2308 E MAIN ST STE ANew Iberia, LA 70560-4029
Mailing Address2308 E Main St Ste ANew Iberia, LA 70560-4029 · (337) 408-8676
Phone(337) 408-8676
Organization SubpartYes
Authorized OfficialMark Robert EldredgeAo · (337) 769-7779
Enumeration DateNovember 10, 2022
Last NPPES UpdateApril 2, 20244 updates tracked since enumeration
NPPES CertifiedApril 2, 2024
✔ NPI 1104534965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
2308 E MAIN ST STE A, New Iberia, LA 70560
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 19D2119405

Southern Urology, LLC · New Iberia, LA
Active · expires Sep 26, 2026
CLIA Number19D2119405
Laboratory TypePhysician Office
Certificate Effective DateSeptember 27, 2024
Certificate Expiration DateSeptember 26, 2026
Laboratory DirectorAndre P. Broussard
Laboratory Phone(337) 408-8676
Laboratory LocationSouthern Urology, LLC2308 East Main Street, Suite A, New Iberia, LA 70560
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 19D2299632

Southern Urology, LLC · Crowley, LA
Active · expires Feb 22, 2028
CLIA Number19D2299632
Laboratory TypePhysician Office
Certificate Effective DateFebruary 23, 2026
Certificate Expiration DateFebruary 22, 2028
Laboratory DirectorJason Bourque
Laboratory Phone(337) 769-7779
Laboratory LocationSouthern Urology, LLC1325 Wright Ave, Ste J, Crowley, LA 70526
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Urology LLC's NPI number?

The NPI number for Southern Urology LLC is 1104534965. It was assigned to this organization in the NPPES registry on November 10, 2022.

Where is Southern Urology LLC located?

Southern Urology LLC is located at 2308 E Main St Ste A, New Iberia, LA 70560. The listed phone number is (337) 408-8676.

What is Southern Urology LLC's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Does Southern Urology LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Southern Urology LLC was last updated on April 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.