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Organization
GANDY EYE CARE A PROFESSIONAL
Active
Organization
GANDY EYE CARE A PROFESSIONAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACY G GANDY O.D. (DOCTOR)
(318) 728-2299
Entity
Organization
Contact information
Practice address
107 MAXWELL DR, RAYVILLE, LA 71269-5558
(318) 728-2299
(318) 728-0081
Mailing address
107 MAXWELL DR, RAYVILLE, LA 71269-5558
(318) 728-2299
(318) 728-0081
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1945811
—
LA
01
—
2455B
BLUECROSSBLUESHIELD OF LA
LA
Enumeration date
07/03/2007
Last updated
01/06/2011
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