Healthcare Provider Details

I. General information

NPI: 1285657296
Provider Name (Legal Business Name): STEVE D. GILL OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 NAPOLEON AVE SUITE 750
NEW ORLEANS LA
70115
US

IV. Provider business mailing address

1407 SWEET BAY CT
COVINGTON LA
70433-5085
US

V. Phone/Fax

Practice location:
  • Phone: 504-412-1210
  • Fax:
Mailing address:
  • Phone: 866-264-1898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number970-277T
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number970-277T
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: