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General NPI Number Information
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NPI Number | 1215048624
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Entity Type | Organization
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Legal Business Name | DAVID H FISHER JR INC THE VISION CLINIC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 1458 S COLLEGE RD
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City | LAFAYETTE
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State | LA
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Zip | 70503-2912
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Country | US
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Telephone | 337-237-2110
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Fax | 337-237-1632
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Provider Business Mailing Address
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Address Line | 1458 S COLLEGE RD
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City | LAFAYETTE
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State | LA
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Zip | 70503-2912
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Country | US
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Telephone | 337-237-2110
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Fax | 337-237-1632
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. DAVID H FISHER JR.
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Credential | OD
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Telephone | 337-237-2110
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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 | 1069-201-T
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License Number State | LA
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