Individual
WESTON WHITWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
8889 JEWELLA AVE, SHREVEPORT, LA 71118-2138
(318) 686-5227
Mailing address
8889 JEWELLA AVE, SHREVEPORT, LA 71118-2138
(318) 686-5227
(318) 716-3376
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
10284
TX
152W00000X
Optometrist
Primary
1933-869AT
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/30/2021
Last updated
07/14/2021
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