Dean, Elmo Clyde
Dean, Elmo Clyde is an sole proprietor health care provider with primary practice located at 4747 Oneal Ln Ste. A, Baton Rouge LA 70817-1638. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Dean, Elmo Clyde can be contacted via phone (225) 755-0988.Contact Information
Primary practice address
4747 Oneal Ln Ste. A
Baton Rouge LA 70817-1638
Phone: (225) 755-0988
Fax: (225) 755-3235
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 843-071T | Louisiana |
Profile Details
| NPI number | 1972595460 |
|---|---|
| LBN Legal business name | Dean, Elmo Clyde |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 19th, 2005 |
| Last updated | Jan 10th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972595460 | NPPES |
| Louisiana | MEDICAID | 1317918 |
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