# SHREVEPORT EYE SPECIALISTS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528587441
- **Authorized official:** DR. RUSSELL H VAN NORMAN MD (OWNER)
- **Authorized official phone:** (318) 703-5655

## Contact information

- **Practice address:** 1801 FAIRFIELD AVE STE 207, SHREVEPORT, LA 71101-4460
- **Practice address phone:** (318) 489-5949
- **Mailing address:** 1801 FAIRFIELD AVE STE 207, SHREVEPORT, LA 71101-4460
- **Mailing address phone:** (318) 703-5655
- **Mailing address fax:** (318) 606-5470

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | MD.024870 | LA | Yes |

## Other

- **Enumeration date:** 09/12/2017
- **Last updated:** 01/25/2018