Mcclure, Eddie Dale
Mcclure, Eddie Dale is an individual health care provider with primary practice located at 5368 Kennesaw Dr , Baton Rouge LA 70817-2555. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Mcclure, Eddie Dale can be contacted via phone (225) 753-0441.Contact Information
Primary practice address
5368 Kennesaw Dr
Baton Rouge LA 70817-2555
Phone: (225) 753-0441
Fax: (225) 753-3320
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optician | 156FX1800X | 10-00013656 | Louisiana |
Profile Details
| NPI number | 1750662474 |
|---|---|
| LBN Legal business name | Mcclure, Eddie Dale |
| Credentials | OPTICIAN |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 8th, 2011 |
| Last updated | Sep 8th, 2011 - about 15 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 | 1750662474 | NPPES |
| Louisiana | Other | 1508876095 | MEDICAID NPI NUMBER |
| Louisiana | MEDICAID | 1156612 | MEDICAID NPI NUMBER |
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