Mr Larry L Waggoner, DOCTOR OF OPTOMETRY is a medicare enrolled "Optometrist" provider in Lake Isabella, California. His current practice location is
12134 Mt Mesa Rd, Lake Isabella, California. You can reach out to his office (for appointments etc.) via phone at
(760) 379-3602.
Mr Larry L Waggoner is licensed to practice in California (license number 6133T) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1710065727.
Healthcare Provider's Profile
Full Name | Mr Larry L Waggoner |
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Gender | Male |
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Speciality | |
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Experience | Years |
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Location | 12134 Mt Mesa Rd, Lake Isabella, California |
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Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mr Larry L Waggoner attended and graduated from in
NPI Data:
- NPI Number: 1710065727
- Provider Enumeration Date: 11/01/2006
- Last Update Date: 08/23/2010
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Mr Larry L Waggoner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1710065727 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
152W00000X | Optometrist | 6133T (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Larry L Waggoner is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Larry L Waggoner, DOCTOR OF OPTOMETRY 12134 Mt Mesa Rd, Lake Isabella, CA 93240 Ph: (760) 379-3602 | Mr Larry L Waggoner, DOCTOR OF OPTOMETRY 12134 Mt Mesa Rd, Lake Isabella, CA 93240 Ph: (760) 379-3602 |
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