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General NPI Number Information
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NPI Number | 1164642740
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Entity Type | Organization
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Legal Business Name | RICHARD J PICCIONE MD APMC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 4906 AMBASSADOR CAFFERY PKWY STE. 701
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City | LAFAYETTE
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State | LA
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Zip | 70508-6916
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Country | US
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Telephone | 337-989-2600
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Fax | 337-989-2601
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Provider Business Mailing Address
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Address Line | 4906 AMBASSADOR CAFFERY PKWY STE. 701
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City | LAFAYETTE
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State | LA
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Zip | 70508-6916
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Country | US
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Telephone | 337-989-2600
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Fax | 337-989-2601
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RICHARD JAMES PICCIONE
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Credential | MD
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Telephone | 337-989-2600
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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 | LA 1392-523T
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD.09888R
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License Number State | LA
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