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Organization
GERMER HALEY LLC
Active
Organization
GERMER HALEY LLC
Active
Other names
Eye Surgery Center of Louisiana
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILIAM DAVE WILLIS (ADMINISTRATOR)
(504) 455-1816
Entity
Organization
Contact information
Practice address
409 AVENUE F, BOGALUSA, LA 70427-3633
(985) 735-8137
(504) 887-7816
Mailing address
3900 VETERANS MEMORIAL BLVD, SUITE 203, METAIRIE, LA 70002-5634
(504) 455-1816
(504) 887-7816
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00134738
—
MS
05
—
09015514
—
MS
05
—
1441121
—
LA
Enumeration date
10/15/2007
Last updated
09/15/2010
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