| |
18522 Magnolia Bridge Rd Ste A, Greenwell Springs, LA 70739-4628 | |
(225) 261-6282 | |
(225) 261-6012 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 18522 Magnolia Bridge Rd Ste A, Greenwell Springs, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336370618 | NPI | - | NPPES |
1459518 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1560-592T (Louisiana) | Primary |
Provider Name | Kevin A Rogers |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1760647960 PECOS PAC ID: 1759458342 Enrollment ID: I20080924000019 |
Mailing Address | Practice Location Address |
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18522 Magnolia Bridge Rd Ste A, Greenwell Springs, LA 70739-4628 Ph: (225) 261-6282 | 18522 Magnolia Bridge Rd Ste A, Greenwell Springs, LA 70739-4628 Ph: (225) 261-6282 |
Dr. Kevin A Rogers, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 18522 Magnolia Bridge Rd, Suite A, Greenwell Springs, LA 70739 Phone: 225-261-6282 Fax: 225-261-6012 |