REGIONAL UROLOGY ASC LLC NPI 1265437743

NPI Information

NPI: 1265437743
Provider Name: REGIONAL UROLOGY ASC LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 19D2259783

Address:
255 BERT KOUNS LOOP
SHREVEPORT, LA
ZIP 71106
Phone: (318) 683-0411
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REGIONAL UROLOGY ASC LLC is an ambulatory surgical clinic center in Shreveport, LA. REGIONAL UROLOGY ASC LLC NPI is 1265437743. The provider is registered as an organization entity type.

The provider's business location address is:

255 BERT KOUNS LOOP
SHREVEPORT, LA
ZIP 71106-150
Phone: (318) 683-0411
Fax: (318) 603-5461

The provider's authorized official is Thomas E Palmer .
The authorized official title is Board Member and has the following contact phone number (318) 683-0411.

The CLIA number assigned to this NPI record is 19D2259783 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/20/2005 and was last updated on 1/7/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	100	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	490004967	OTHER		RAILROAD MEDICARE
2	1180793	MEDICAID	LOUISIANA
3	20117	OTHER	LOUISIANA	BLUE CROSS OF LA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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