Provider Demographics
NPI:1396742698
Name:BOND, R HUNTER (OD)
Entity type:Individual
Prefix:
First Name:R
Middle Name:HUNTER
Last Name:BOND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60007 W WAY DR
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-4186
Mailing Address - Country:US
Mailing Address - Phone:985-748-8096
Mailing Address - Fax:985-748-4376
Practice Address - Street 1:60007 WEST WAY DRIVE
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422
Practice Address - Country:US
Practice Address - Phone:985-748-8096
Practice Address - Fax:985-748-4376
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1216-377AT152W00000X
LA1216-377T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1687561Medicaid
LA1173500001Medicare NSC
LAU63525Medicare UPIN
LA4B220Medicare PIN