Dorothy K Anderson, OD
Individual provider Active NPI Optometrist · Marrero, LA
NPI 1679659593 · NPPES record last updated Mar 11, 2008
Key facts
- NPI
- 1679659593
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 7291761 (LA)
- Practice address
- 1670 Barataria Blvd
Ste D
Marrero, LA 70072-4354 - Phone
- (504) 348-2993
- Fax
- (504) 340-4468
- NPI assigned
- Oct 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 729 | LA | MD | Addiction (Substance Use Disorder) Counselor |
| 7291761 | LA | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 7291761 | LA | Yes |
Addresses
Primary practice location
1670 Barataria Blvd
Ste D
Marrero, LA 70072-4354
Mailing address
1670 Barataria Blvd
Ste D
Marrero, LA 70072-4354
Phone (504) 348-2993
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1143456 | Medicaid | LA |
Other providers in Marrero, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.