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General NPI Number Information
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NPI Number | 1033319272
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Entity Type | Organization
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Legal Business Name | DOROTHY K. ANDERSON, O.D.
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 1670 BARATARIA BLVD STE D
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City | MARRERO
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State | LA
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Zip | 70072-4354
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Country | US
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Telephone | 504-348-2993
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Fax | 504-340-4468
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Provider Business Mailing Address
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Address Line | 1670 BARATARIA BLVD STE D
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City | MARRERO
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State | LA
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Zip | 70072-4354
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Country | US
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Telephone | 504-348-2993
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Fax | 504-340-4468
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Authorized Official
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Title or Position | O.D./OWNER
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Name | DR. DOROTHY K. ANDERSON
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Credential | O.D.
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Telephone | 504-348-2993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 729-176T
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License Number State | LA
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