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General NPI Number Information
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NPI Number | 1144418484
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Entity Type | Organization
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Legal Business Name | ACCURATE EYE CARE LLC
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 900 CANAL BLVD SUITE 3
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City | THIBODAUX
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State | LA
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Zip | 70301-4506
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Country | US
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Telephone | 985-448-3353
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Fax | 985-448-1276
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Provider Business Mailing Address
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Address Line | 900 CANAL BLVD SUITE 3
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City | THIBODAUX
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State | LA
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Zip | 70301-4506
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Country | US
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Telephone | 985-448-3353
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Fax | 985-448-1276
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. KEITH E KELLUM
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Credential | M.D.
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Telephone | 985-448-3353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 12816R
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License Number State | LA
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