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M. DWAYNE YEAGER OD FAAO A PROFESSIONAL ORGANIZATION NPI 1407156847


NPI Information

NPI: 1407156847
Provider Name: M. DWAYNE YEAGER, OD, FAAO, A PROFESSIONAL ORGANIZATION
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
3805 CYPRESS ST
WEST MONROE, LA
ZIP 71291
Phone: (318) 325-3937
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M. DWAYNE YEAGER, OD, FAAO, A PROFESSIONAL ORGANIZATION is a prosthetic orthotic supplier in West Monroe, LA. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. M. DWAYNE YEAGER, OD, FAAO, A PROFESSIONAL ORGANIZATION NPI is 1407156847. The provider is registered as an organization entity type.

The provider's business location address is:

3805 CYPRESS ST
WEST MONROE, LA
ZIP 71291-436
Phone: (318) 325-3937
Fax: (318) 397-9717

The provider's authorized official is M Dwayne Yeager .
The authorized official title is Optometrist and has the following contact phone number (318) 325-3937.

The enumeration date for this NPI number is 11/2/2010 and was last updated on 12/9/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335E00000XProsthetic/Orthotic Supplier1020-199TLOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11369004MEDICAIDLOUISIANA
2T19545MEDICARE UPINLOUISIANA
30405150001MEDICARE NSCLOUISIANA
45DQ74MEDICARE PINLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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