Provider Demographics
NPI:1861593477
Name:ACHORD, SHONDA D (OD)
Entity type:Individual
Prefix:DR
First Name:SHONDA
Middle Name:D
Last Name:ACHORD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12726 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1910
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:70810-1910
Practice Address - Country:US
Practice Address - Phone:225-767-3937
Practice Address - Fax:225-767-3917
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1095-205T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1952524Medicaid
LA4B024Medicare ID - Type Unspecified
LA1952524Medicaid