Amy Elizabeth Coburn, O.D.
Optometrist in Shreveport, LA. Individual provider (NPI-1).
NPI number1871729277
StatusActive
Last updated in NPPESDec 11, 2020
Details
- NPI
- 1871729277
- Entity type
- Individual (NPI-1)
- Name
- Amy Elizabeth Coburn
- Credential
- O.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 1, 2009
- Certification date
- Dec 11, 2020
- Last updated
- Dec 11, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 1574-607T | LA | Yes |
Practice location
Highland Clinic, Apmc1400 E. Bert Kouns, Suite #103
Shreveport, LA 71105
Phone 318-222-8402 · Fax 318-222-4556
Mailing address
Highland Clinic, Apmc1400 E. Bert Kouns, Suite #103
Shreveport, LA 71105
Phone 318-222-8402 · Fax 318-222-4556
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