Organization
RETINA & VITREOUS OF LOUISIANA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN T. COUVILLION M.D. (PRESIDENT)
(225) 768-8833
Entity
Organization
Contact information
Practice address
10202 JEFFERSON HWY STE D, BATON ROUGE, LA 70809-3183
(225) 768-8833
(225) 769-4839
Mailing address
10202 JEFFERSON HWY STE D, BATON ROUGE, LA 70809-3183
(225) 768-8833
(225) 769-4839
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
021851
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009113
—
LA
Enumeration date
04/11/2007
Last updated
10/11/2018
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