Active NPI
Martin Luther Laird IV, M.D.
- Ophthalmology Physician
- Pineville, LA
National Provider Identifier
1861607467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 12164R
- Practice address
- 2495 Shreveport Hwy
Pineville, LA 71360-4044 - Phone
- (318) 473-0010
- NPI assigned
- May 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 12164R | LA | Primary |
Addresses
Primary practice location
2495 Shreveport Hwy
Pineville, LA 71360-4044
Mailing address
6103 Bayou Robert Dr
Alexandria, LA 71301-2663
Phone (318) 229-9238
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1695874 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12164R | LA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861607467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6103 BAYOU ROBERT DR",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713012663",
"telephone_number": "318-229-9238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2495 SHREVEPORT HWY",
"city": "PINEVILLE",
"state": "LA",
"postal_code": "713604044",
"telephone_number": "318-473-0010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAIRD",
"first_name": "MARTIN",
"middle_name": "LUTHER",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "LA",
"license": "12164R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1695874",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pineville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.