Organization
ALEXANDRIA EYE AND LASER CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIA JACKSON WILLIAMS (CREDENTIALING SPECIALIST)
(318) 561-0946
Entity
Organization
Contact information
Practice address
65 MEDICAL PARK BLVD, PINEVILLE, LA 71360-8428
(318) 641-2400
(318) 441-9976
Mailing address
231 WINDERMERE BLVD, ALEXANDRIA, LA 71303-3538
(318) 487-2020
(318) 427-0181
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1441210
—
LA
Enumeration date
09/28/2015
Last updated
01/19/2022
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