Individual
PEGGY H GRAMATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
Mailing address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036-097318
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831123181
NPI NUMBER
IL
01
—
289730001
PTAN
IL
Enumeration date
07/11/2006
Last updated
09/01/2016
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