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Organization
ALEXANDRIA EYE AND LASER CENTER, LLC
Active
Organization
ALEXANDRIA EYE AND LASER CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIA JACKSON WILLIAMS (CREDENTIALING SPECIALIST)
(318) 561-0946
Entity
Organization
Contact information
Practice address
1008 S 6TH ST, LEESVILLE, LA 71446-4920
(337) 392-1994
(337) 392-1944
Mailing address
231 WINDERMERE BLVD, ALEXANDRIA, LA 71303-3538
(318) 487-2020
(318) 445-7745
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
NULL
152W00000X
Optometrist
Primary
—
—
207W00000X
Ophthalmology Physician
—
NULL
207W00000X
Ophthalmology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1441210
—
LA
01
—
DC4592
TRAVELERS MEDICARE
LA
Enumeration date
02/27/2008
Last updated
01/10/2025
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