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:
Health care specialties
| Specialty | Code | License # | 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 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861410730 | NPPES |
| Louisiana | MEDICAID | 1578240 | |
| Louisiana | MEDICAID | 1150631 | |
| Louisiana | Other | 1578240 |
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