Pickering, Michael David

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

Contact Information

Primary practice address
5848 Line Ave Shreveport LA 71106-1532
Phone: (318) 865-0017
Fax: (318) 868-4738
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 963-247T Louisiana

Profile Details

NPI number 1114022175
LBN Legal business name Pickering, Michael David
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2006
Last updated Dec 5th, 2013 - about 12 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 1114022175 NPPES
Louisiana MEDICAID 1362549
Louisiana Other 2504B

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