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General NPI Number Information
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NPI Number | 1831282524
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Entity Type | Organization
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Legal Business Name | WESTSIDE EYE CLINIC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4601 WICHERS DR
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City | MARRERO
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State | LA
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Zip | 70072-3049
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Country | US
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Telephone | 504-347-8434
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Fax | 504-347-9868
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Provider Business Mailing Address
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Address Line | 4601 WICHERS DR
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City | MARRERO
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State | LA
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Zip | 70072-3049
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Country | US
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Telephone | 504-347-8434
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Fax | 504-347-9868
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EARL J SONNIER
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Credential | MD
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Telephone | 504-347-8434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | LA
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