| Dr Richard L Granger, OD | |
|
10900 Highway 3125, Suite F, Lutcher, LA 70071-5639 | |
| (225) 869-5043 | |
| (225) 869-8400 |
| Full Name | Dr Richard L Granger |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 10900 Highway 3125, Lutcher, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720058878 | NPI | - | NPPES |
| 1360163 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | LA. 976-139T (Louisiana) | Secondary |
| 152W00000X | Optometrist | 976-139T (Louisiana) | Primary |
| Provider Name | Williamson Eye Center |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1699812909 PECOS PAC ID: 9335131192 Enrollment ID: O20040401000144 |
| Provider Name | Jason Wonch, O.d. And Associates, A.p.c. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1295769008 PECOS PAC ID: 8426040940 Enrollment ID: O20040402000193 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Richard L Granger, OD 10900 Highway 3125, Suite F, Lutcher, LA 70071-5639 Ph: (225) 869-5043 | Dr Richard L Granger, OD 10900 Highway 3125, Suite F, Lutcher, LA 70071-5639 Ph: (225) 869-5043 |
Williamson Eye Center Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2468 Louisiana Ave, Lutcher, LA 70071 Phone: 225-869-5043 Fax: 225-869-8400 | |
Dustin Michael Weidert, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2468 Louisiana Ave, Lutcher, LA 70071 Phone: 225-869-5043 Fax: 225-869-8400 |