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NPI Code Detail

MEDICARE: DIMITRI EYE CARE, INC.

MEDICARE: DIMITRI EYE CARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist1098-052TLA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629292941
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIMITRI EYE CARE, INC.
Provider Business Mailing Address
First Line : 701 METAIRIE RD
Second Line : SUITE 205
City : METAIRIE
State : LA
Zip : 70005-4050
Country : US
Telephone Number : 504-837-3937
Fax Number : 504-837-2814
Provider Business Practice Location Address
First Line : 1617 METAIRIE RD
Second Line :
City : METAIRIE
State : LA
Zip : 70005-3976
Country : US
Telephone Number : 504-837-3937
Fax Number : 504-837-9958
Authorized Official
Title or Position : OPTOMETRIST
Name : DR. GEORGE RONALD DIMITRI
Credential : OD
Telephone Number : 504-837-3937
Provider Enumeration Date : 04/11/2007
Last Update Date : 07/06/2024

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Directions to “DIMITRI EYE CARE, INC. ” Practice Location

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