Individual
BRIAN MIKULLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1980 TYBEE ST, LAKE CHARLES, LA 70605-4173
(337) 477-0963
(337) 477-1912
Mailing address
PO BOX 4765, LAKE CHARLES, LA 70606-4765
(337) 477-0963
(337) 477-1912
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD.203922
LA
Other
Enumeration date
05/13/2009
Last updated
07/15/2013
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