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General NPI Number Information
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NPI Number | 1548586696
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Entity Type | Organization
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Legal Business Name | ACADIAN OPTICAL BOUTIQUE LLC
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 10/06/2010
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Provider Practice Location Address
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Address Line | 155 HOSPITAL DR SUITE 300
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City | LAFAYETTE
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State | LA
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Zip | 70503-2852
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Country | US
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Telephone | 337-235-6145
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Fax | 337-234-9629
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Provider Business Mailing Address
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Address Line | 155 HOSPITAL DR SUITE 300
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City | LAFAYETTE
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State | LA
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Zip | 70503-2852
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Country | US
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Telephone | 337-235-6145
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Fax | 337-234-9629
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Authorized Official
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Title or Position | OFFICER/OWNER
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Name | DR. HAROLD W. LEDOUX
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Credential | M.D.
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Telephone | 337-235-6145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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