Gregory, Chesley Lelwynn

Gregory, Chesley Lelwynn is an individual health care provider with primary practice located at 9425 Healthplex Dr Ste 101 , Shreveport LA 71106-8154. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Gregory, Chesley Lelwynn can be contacted via phone (318) 683-5171.

Contact Information

Primary practice address
9425 Healthplex Dr Ste 101 Shreveport LA 71106-8154
Phone: (318) 683-5171
Fax: (318) 683-5182
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 765-002T Louisiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 202699 Louisiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 202699 Louisiana

Profile Details

NPI number 1861410730
LBN Legal business name Gregory, Chesley Lelwynn
Credentials M.D. ,O.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Dec 3rd, 2019 - about 6 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 1861410730 NPPES
Louisiana MEDICAID 1578240
Louisiana MEDICAID 1150631
Louisiana Other 1578240

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