REGIONAL UROLOGY ASC LLC
Surgery Yellow Pages
Shreveport, Louisiana
Provider NPI: 1265437743
Organization Information:Organization Name: REGIONAL UROLOGY ASC LLC
Practice Location:
255 BERT KOUNS LOOP SHREVEPORT, LA 71106 US
Tel: 318-683-0411 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
255 BERT KOUNS LOOP SHREVEPORT, LA 71106 US
Tel: 318-683-0411 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 261QA1903X | Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical | LA | 100 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
RAILROAD MEDICARE | 490004967 | 01 | |
1180793 | LA | 05 | |
BLUE CROSS OF LA | 20117 | LA | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin