Eye Central Mansfield Llc | |
405 Polk St, Mansfield, LA 71052-2400 | |
(318) 872-0747 | |
(318) 716-3376 |
Full Name | Eye Central Mansfield Llc |
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Type | Facility |
Speciality | Optometrist |
Location | 405 Polk St, Mansfield, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1457856296 | NPI | - | NPPES |
2379054 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | 1775-709AT (Louisiana) | Primary |
Provider Name | Noel S Taylor |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1154553071 PECOS PAC ID: 5294880738 Enrollment ID: I20090904000061 |
Provider Name | Bradly Kendall Larson |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1053729152 PECOS PAC ID: 3274856562 Enrollment ID: I20141217001051 |
Mailing Address | Practice Location Address |
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Eye Central Mansfield Llc 313 Griffin Dr, Stonewall, LA 71078-5411 Ph: (318) 963-1055 | Eye Central Mansfield Llc 405 Polk St, Mansfield, LA 71052-2400 Ph: (318) 872-0747 |
Dr. Walter B Blankenship, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 126 Jefferson St, Mansfield, LA 71052 Phone: 318-872-0747 Fax: 318-872-0748 | |
Christopher Shelby M D A Professional Medical Corporation Optometrist Medicare: Not Enrolled in Medicare Practice Location: 126 Jefferson St, Mansfield, LA 71052 Phone: 318-872-0747 |