Individual
DR. MARTIN LUTHER LAIRD IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
Mailing address
6103 BAYOU ROBERT DR, ALEXANDRIA, LA 71301-2663
(318) 229-9238
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
12164R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1695874
—
LA
Enumeration date
05/14/2007
Last updated
07/08/2007
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