Provider Demographics
NPI:1548296940
Name:ACHORD EYE CLINIC
Entity type:Organization
Organization Name:ACHORD EYE CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHONDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ACHORD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:225-767-3937
Mailing Address - Street 1:12726 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810
Mailing Address - Country:US
Mailing Address - Phone:225-767-3937
Mailing Address - Fax:225-767-3917
Practice Address - Street 1:12726 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810
Practice Address - Country:US
Practice Address - Phone:225-767-3937
Practice Address - Fax:225-767-3917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1095205T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1952524Medicaid
LA4B024Medicare ID - Type Unspecified
LA1952524Medicaid