| Eye Central Mansfield Llc | |
|
405 Polk St, Mansfield, LA 71052-2400 | |
| (318) 872-0747 | |
| (318) 716-3376 |
| Full Name | Eye Central Mansfield Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 405 Polk St, Mansfield, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457856296 | NPI | - | NPPES |
| 2379054 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 1775-709AT (Louisiana) | Primary |
| Provider Name | Noel Scott Taylor |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154553071 PECOS PAC ID: 5294880738 Enrollment ID: I20090904000061 |
| Mailing Address | Practice Location Address |
|---|---|
| Eye Central Mansfield Llc 313 Griffin Dr, Stonewall, LA 71078-5411 Ph: (318) 963-1055 | Eye Central Mansfield Llc 405 Polk St, Mansfield, LA 71052-2400 Ph: (318) 872-0747 |
Dr. Walter B Blankenship, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 126 Jefferson St, Mansfield, LA 71052 Phone: 318-872-0747 Fax: 318-872-0748 | |
Christopher Shelby M D A Professional Medical Corporation Optometrist Medicare: Not Enrolled in Medicare Practice Location: 126 Jefferson St, Mansfield, LA 71052 Phone: 318-872-0747 |