Provider Demographics
NPI:1770565244
Name:IGLINSKY, WILLIAM L (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:IGLINSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:LAWRENCE
Other - Last Name:IGLINSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1717 OAK PARK BLVD.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8991
Mailing Address - Country:US
Mailing Address - Phone:337-478-3810
Mailing Address - Fax:337-478-6360
Practice Address - Street 1:1717 OAK PARK BLVD.
Practice Address - Street 2:SUITE 1
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8991
Practice Address - Country:US
Practice Address - Phone:337-478-3810
Practice Address - Fax:337-478-6360
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA013803174400000X
LA13803207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1341614Medicaid
LA5407174OtherAETNA
LA720680677010OtherCIGNA
LA1341614Medicaid
LAB61945Medicare UPIN