Healthcare Provider Details

I. General information

NPI: 1194655522
Provider Name (Legal Business Name): BAILEY RYAN LEMOINE OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2451
US

IV. Provider business mailing address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2451
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-3208
  • Fax: 504-842-6883
Mailing address:
  • Phone: 504-842-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2076-023AT
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: