| Dr Ira Butler Fuller Iii Iii, MD | |
|
433 Plaza St, Bogalusa, LA 70427-3729 | |
| (985) 730-6705 | |
| (985) 730-6709 |
| Full Name | Dr Ira Butler Fuller Iii Iii |
|---|---|
| Gender | Male |
| Speciality | Ophthalmology |
| Location | 433 Plaza St, Bogalusa, Louisiana |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134149081 | NPI | - | NPPES |
| 1341428 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207W00000X | Ophthalmology | 06356R (Louisiana) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ira Butler Fuller Iii Iii, MD 3401 North Blvd, Baton Rouge, LA 70806-3743 Ph: (225) 924-6820 | Dr Ira Butler Fuller Iii Iii, MD 433 Plaza St, Bogalusa, LA 70427-3729 Ph: (985) 730-6705 |
Mr. Randy Peter Bouligny, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 409 Avenue F, Bogalusa, LA 70427 Phone: 504-455-1816 Fax: 504-887-7816 | |
Maria Delpilar Bernal, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 433 Plaza St Rm 213, Bogalusa, LA 70427 Phone: 985-730-7209 Fax: 985-730-7210 |