Brogden, Alisa Kay

Brogden, Alisa Kay is an individual health care provider with primary practice located at 5848 Line Ave , Shreveport LA 71106-1532. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Brogden, Alisa Kay can be contacted via phone (318) 865-0017.

Contact Information

Primary practice address
5848 Line Ave Shreveport LA 71106-1532
Fax: (318) 868-4738
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1533-563T Louisiana

Profile Details

NPI number 1598878860
LBN Legal business name Brogden, Alisa Kay
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2006
Last updated Apr 11th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598878860 NPPES
Louisiana MEDICAID 1715204

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