Individual
BRYAN ELLIOT LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
451 ASHLEY RIDGE BLVD, SHREVEPORT, LA 71106-7229
(318) 222-5555
(318) 222-6414
Mailing address
451 ASHLEY RIDGE BLVD, SHREVEPORT, LA 71106-7229
(318) 222-5555
(318) 222-6414
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
203516
LA
207W00000X
Ophthalmology Physician
62138
GA
Other
Enumeration date
05/19/2008
Last updated
04/07/2010
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