Individual
DR. MICHAEL DAVID PICKERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5848 LINE AVE, SHREVEPORT, LA 71106-1532
(318) 865-0017
(318) 868-4738
Mailing address
5848 LINE AVE, SHREVEPORT, LA 71106-1532
(318) 865-0017
(318) 868-4738
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
963-247T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1362549
—
LA
01
—
2504B
BCBS
LA
Enumeration date
09/14/2006
Last updated
12/05/2013
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