Larry E Waggoner O D Prof Corp is a
Optometrist based in Lake Isabella, California. Larry E Waggoner O D Prof Corp is licensed to practice in California (license number 6133) and their current practice location is
12134 Mount Mesa Rd, Lake Isabella, California. It can be reached at their office (for appointments etc.) via phone at
(760) 379-3602.
NPI number for Larry E Waggoner O D Prof Corp is 1336449388 and their current mailing address is 12134 Mount Mesa Rd, Lake Isabella, California. Larry E Waggoner O D Prof Corp
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1336449388.
Healthcare Provider's Profile
| Full Name | Larry E Waggoner O D Prof Corp |
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| Type | Facility |
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| Speciality | Optometrist |
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| Location | 12134 Mount Mesa Rd, Lake Isabella, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1336449388
- Provider Enumeration Date: 10/25/2010
- Last Update Date: 11/22/2010
Medical Identifiers
Medical identifiers for Larry E Waggoner O D Prof Corp such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1336449388 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 6133 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Larry E Waggoner O D Prof Corp is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Larry E Waggoner O D Prof Corp
12134 Mount Mesa Rd,
Lake Isabella, CA 93240-9690
Ph: (760) 379-3602 | Larry E Waggoner O D Prof Corp
12134 Mount Mesa Rd,
Lake Isabella, CA 93240-9690
Ph: (760) 379-3602 |
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