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2434 Highway 171, Stonewall, LA 71078-9420 | |
(318) 925-2345 | |
(318) 925-3456 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 2434 Highway 171, Stonewall, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215398631 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Alisa K Brogden |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1598878860 PECOS PAC ID: 6103928478 Enrollment ID: I20070217000045 |
Provider Name | Neil W Brogden |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1265545644 PECOS PAC ID: 9739281924 Enrollment ID: I20070219000239 |
Mailing Address | Practice Location Address |
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405 Polk St, Mansfield, LA 71052-2421 Ph: (318) 872-0747 | 2434 Highway 171, Stonewall, LA 71078-9420 Ph: (318) 925-2345 |
Noel Scott Taylor, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2434 Highway 171, Stonewall, LA 71078 Phone: 318-925-2345 Fax: 318-925-3456 |