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General NPI Number Information
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NPI Number | 1508029190
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Entity Type | Organization
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Legal Business Name | SURGICAL EYE ASSOCIATES
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 803 RIVERSIDE DR
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City | FRANKLINTON
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State | LA
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Zip | 70438-3635
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Country | US
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Telephone | 985-839-5633
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Fax | 983-839-7988
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Provider Business Mailing Address
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Address Line | 1120 N HIGHWAY 190
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City | COVINGTON
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State | LA
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Zip | 70433-5178
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Country | US
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Telephone | 985-893-5777
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Fax | 985-867-4224
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Authorized Official
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Title or Position | MANAGING OFFICER
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Name | RICHARD O BESSENT
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Credential | MD
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Telephone | 985-893-5777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | LA
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