Organization
SHREVEPORT EYE SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL H VAN NORMAN MD (OWNER)
(318) 703-5655
Entity
Organization
Contact information
Practice address
1801 FAIRFIELD AVE STE 207, SHREVEPORT, LA 71101-4460
(318) 489-5949
Mailing address
1801 FAIRFIELD AVE STE 207, SHREVEPORT, LA 71101-4460
(318) 703-5655
(318) 606-5470
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD.024870
LA
Other
Enumeration date
09/12/2017
Last updated
01/25/2018
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