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Eddie Dale Mcclure, OPTICIAN
Optician in Baton Rouge, Louisiana
NPI 1750662474

Eddie Dale Mcclure is a Optician based in Bossier City, LA and is specialized in Optician. Eddie Dale Mcclure practices in Baton Rouge, LA and has the professional credentials of OPTICIAN. The NPI Number for Eddie Dale Mcclure is 1750662474 and holds a License No. 10-00013656 (Louisiana).

The current practice location address for Eddie Dale Mcclure is 5368 Kennesaw Dr, Baton Rouge, LA and can be reached out via phone at 225-753-0441 and via fax at 225-753-3320. You can also correspond with Eddie Dale Mcclure through the mailing address at 3153 E TEXAS ST, BOSSIER CITY, LA - 71111-3209 (mailing address contact number: 225-753-0441).

Location: 5368 Kennesaw Dr, Baton Rouge, LA, 71111-3209
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Provider Profile Details
NPI Number
1750662474
Provider Name
Eddie Dale Mcclure
Credential
OPTICIAN
Provider Entity Type
Individual
Gender
Male
Address
5368 Kennesaw Dr, Baton Rouge, LA, 71111-3209
Phone Number
225-753-0441
Fax Number
225-753-3320
Provider Enumeration Date
09/08/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1508876095 01 LA MEDICAID NPI NUMBER
1156612 05 LA
institution
Provider Business Practice Location Address Details
Address
5368 Kennesaw Dr
City
State
Zip
70817-2555
Phone Number
225-753-0441
Fax Number
225-753-3320
person
Provider Business Mailing Address Details
Address
5368 Kennesaw Dr
City
State
Zip
70817-2555
Phone Number
225-753-0441
Fax Number
225-753-3320
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
License No.
10-00013656 (Louisiana)
Definition
Definition to come...
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