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
1008 S 6TH ST, LEESVILLE, LA 71446-4920
(337) 392-1994
(337) 392-1944
Mailing address
231 WINDERMERE BLVD, ALEXANDRIA, LA 71303-3538
(318) 487-2020
(318) 445-7745
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
207W00000X
Ophthalmology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1441210
—
LA
01
—
DC4592
TRAVELERS MEDICARE
LA
Enumeration date
02/27/2008
Last updated
01/10/2025
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