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General NPI Number Information
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NPI Number | 1992709885
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Entity Type | Organization
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Legal Business Name | THE RETINAL INSTITUTE OF LOUISIANA
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10001 LAKE FOREST BLVD STE 701
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City | NEW ORLEANS
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State | LA
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Zip | 70127-5264
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Country | US
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Telephone | 504-246-1966
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Fax | 504-241-0743
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Provider Business Mailing Address
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Address Line | 10001 LAKE FOREST BLVD STE 701
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City | NEW ORLEANS
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State | LA
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Zip | 70127-5264
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Country | US
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Telephone | 504-246-1966
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Fax | 504-241-0743
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVID ANTHONY NEWSOME
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Credential | M.D.
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Telephone | 504-246-1966
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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 | 072372
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License Number State | LA
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