Gordon, William David

Gordon, William David is an sole proprietor health care provider with primary practice located at 3000 Forsythe Ave , Monroe LA 71201-3012. He recently has 5 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Gordon, William David can be contacted via phone (318) 325-9474.

Contact Information

Primary practice address
3000 Forsythe Ave Monroe LA 71201-3012
Fax: (318) 388-1868
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X LA909-230T Louisiana
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X LA909-230T Louisiana
Eye and Vision Services Providers / Low Vision Rehabilitation 152WL0500X LA909-230T Louisiana
Eye and Vision Services Providers / Pediatrics 152WP0200X LA909-230T Louisiana
Eye and Vision Services Providers / Sports Vision 152WS0006X LA909-230T Louisiana

Profile Details

NPI number 1528050069
LBN Legal business name Gordon, William David
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 19th, 2005
Last updated Jul 8th, 2007 - about 17 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 1528050069 NPPES
Louisiana MEDICAID 1337170

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