Organization
ADVANCED VISION GROUP, LLC
Active
Other names
Precision Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT W JOHNSON (ADMINISTRATIVE DIRECTOR)
(504) 512-2161
Entity
Organization
Contact information
Practice address
3900 VETERANS MEMORIAL BLVD, STE. 100, METAIRIE, LA 70002-5634
(504) 620-2020
(504) 455-2011
Mailing address
39189 OAK ST, PEARL RIVER, LA 70452-5031
(958) 863-2704
(985) 863-3207
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
145
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1471941
—
LA
01
—
7855740
AETNA
LA
01
—
P00184030
RAILROAD MEDICARE
LA
Enumeration date
10/16/2006
Last updated
08/22/2020
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