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General NPI Number Information
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NPI Number | 1558795724
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Entity Type | Organization
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Legal Business Name | LOUISIANA CENTER FOR EYES, LLC
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Dates
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Enumeration Date | 08/24/2013
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Last Update Date | 08/24/2013
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Provider Practice Location Address
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Address Line | 7855 HOWELL PLACE BLVD SUITE 130A
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City | BATON ROUGE
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State | LA
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Zip | 70807-5256
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Country | US
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Telephone | 225-356-2655
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Fax | 225-356-2358
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Provider Business Mailing Address
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Address Line | 7855 HOWELL PLACE BLVD SUITE 130A
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City | BATON ROUGE
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State | LA
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Zip | 70807-5256
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Country | US
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Telephone | 225-356-2655
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Fax | 225-356-2358
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Authorized Official
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Title or Position | OPHTHALMOLOGIST
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Name | CAROLA B. OKOGBAA
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Credential | M.D.
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Telephone | 504-232-0138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 201426
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License Number State | LA
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