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Organization
GEORGE M BAKOWSKI OD PC
Active
Organization
GEORGE M BAKOWSKI OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDY BAKOWSKI (OFFICE MANAGER)
(318) 227-2451
Entity
Organization
Contact information
Practice address
1133 ST. VINCENT AVE # 216 SUITE 120, MALL ST. VINCENT, SHREVEPORT, LA 71104-4147
(318) 221-8445
(318) 227-2442
Mailing address
1133 ST. VINCENT AVE. # 216 SUITE 120, MALL ST. VINCENT, SHREVEPORT, LA 71104-4147
(318) 221-8445
(318) 227-2442
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
738-359T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1150614
—
LA
Enumeration date
02/14/2007
Last updated
02/16/2011
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