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Organization
LOUISIANA RETINA A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
LOUISIANA RETINA A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN BURNHAM MD (OWNER)
(225) 523-7624
Entity
Organization
Contact information
Practice address
303 VETERANS BLVD STE A, DENHAM SPRINGS, LA 70726-4723
(225) 242-9729
Mailing address
303 VETERANS BLVD STE A, DENHAM SPRINGS, LA 70726-4723
(225) 242-9729
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
NULL
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
Other
Enumeration date
10/19/2020
Last updated
05/18/2022
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