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General NPI Number Information
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NPI Number | 1114457140
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Entity Type | Organization
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Legal Business Name | KEITH M. COMEAUX, O.D. APOC
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1301 VICTOR II BLVD STE B
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City | MORGAN CITY
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State | LA
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Zip | 70380-1454
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Country | US
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Telephone | 985-385-5744
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Fax | 985-384-6194
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Provider Business Mailing Address
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Address Line | 1301 VICTOR II BLVD STE B
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City | MORGAN CITY
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State | LA
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Zip | 70380-1454
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Country | US
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Telephone | 985-385-5744
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Fax | 985-384-6194
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MICHELLE STELLY
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Credential |
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Telephone | 985-385-5744
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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 | 1081-050AT
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License Number State | LA
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