# GEORGE M BAKOWSKI OD PC

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

## Provider details

- **NPI number:** 1730222472
- **Authorized official:** MRS. SANDY BAKOWSKI (OFFICE MANAGER)
- **Authorized official phone:** (318) 227-2451

## Contact information

- **Practice address:** 1133 ST. VINCENT AVE \# 216 SUITE 120, MALL ST. VINCENT, SHREVEPORT, LA 71104-4147
- **Practice address phone:** (318) 221-8445
- **Practice address fax:** (318) 227-2442
- **Mailing address:** 1133 ST. VINCENT AVE. \# 216 SUITE 120, MALL ST. VINCENT, SHREVEPORT, LA 71104-4147
- **Mailing address phone:** (318) 221-8445
- **Mailing address fax:** (318) 227-2442

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 738-359T | LA | Yes |

## Other

- **Enumeration date:** 02/14/2007
- **Last updated:** 02/16/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1150614 | — | LA |