Blackmon, Larry E

Blackmon, Larry E is an sole proprietor health care provider with primary practice located at 303 Mcmillan Rd , West Monroe LA 71291-8316. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Blackmon, Larry E can be contacted via phone (318) 387-7257.

Contact Information

Primary practice address
303 Mcmillan Rd West Monroe LA 71291-8316
Fax: (318) 325-7034
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 693-077T Louisiana

Profile Details

NPI number 1902944341
LBN Legal business name Blackmon, Larry E
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2007
Last updated Feb 5th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902944341 NPPES
Louisiana Other LA0693 EYEMED
Louisiana Other 0617300002 EYEMED
Louisiana MEDICAID 1097721 EYEMED
Louisiana Other 2353B EYEMED
Louisiana Other 2864 EYEMED

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