Individual
DR. STACY G GANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
107 MAXWELL DR, RAYVILLE, LA 71269-5558
(318) 728-2299
(318) 728-0081
Mailing address
2651 HIGHWAY 15, MANGHAM, LA 71259-5166
(318) 248-3321
(318) 728-0081
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1114-186T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1959171
—
LA
Enumeration date
06/16/2005
Last updated
01/06/2011
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