Healthcare Provider Details

I. General information

NPI: 1053566653
Provider Name (Legal Business Name): ZAFFATER EYE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2008
Last Update Date: 05/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 HOSPITAL DR SUITE 300
BOSSIER CITY LA
71111-2394
US

IV. Provider business mailing address

2300 HOSPITAL DR SUITE 300
BOSSIER CITY LA
71111-2394
US

V. Phone/Fax

Practice location:
  • Phone: 318-747-5838
  • Fax: 318-747-5827
Mailing address:
  • Phone: 318-747-5838
  • Fax: 318-747-5827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number10876R
License Number StateLA

VIII. Authorized Official

Name: DR. NORMAN ANTHONY ZAFFATER JR.
Title or Position: OWNER
Credential: MD
Phone: 318-747-5838