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Organization

SOUTHERN EYE INSTITUTE LLC

Active
Other names
The Kellum Eye Center
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREA J KIEFER (OFFICE MANAGER)
(985) 872-5577
Entity
Organization

Contact information

Practice address
446 CORPORATE DR, HOUMA, LA 70360
(985) 872-5577
(985) 868-4190
Mailing address
446 CORPORATE DR, HOUMA, LA 70360
(985) 872-5577
(985) 868-4190

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1412-554T
LA
207W00000X
Ophthalmology Physician
011081
LA
207W00000X
Ophthalmology Physician
Primary
022479
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1799718
LA
Enumeration date
11/28/2005
Last updated
02/08/2008
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