Organization
GERMER HALEY LLC
Active
Other names
Eye Surgery Center of Louisiana
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILIAM DAVE WILLIS (ADMINISTRATOR)
(504) 455-1816
Entity
Organization
Contact information
Practice address
409 AVENUE F, BOGALUSA, LA 70427-3633
(985) 735-8137
(504) 887-7816
Mailing address
3900 VETERANS MEMORIAL BLVD, SUITE 203, METAIRIE, LA 70002-5634
(504) 455-1816
(504) 887-7816
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00134738
—
MS
05
—
09015514
—
MS
05
—
1441121
—
LA
Enumeration date
10/15/2007
Last updated
09/15/2010
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