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NPI Code Detail

MEDICARE: DIMAGGIO FAMILY EYE CARE, INC.

MEDICARE: DIMAGGIO FAMILY EYE CARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist1282-438TLA
2152W00000XOptometrist1281-437TLA

General Provider Information

NPI Number : 1023345659
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIMAGGIO FAMILY EYE CARE, INC.
Provider Business Mailing Address
First Line : 1299 HIGHWAY 3226
Second Line :
City : DERIDDER
State : LA
Zip : 70634-9133
Country : US
Telephone Number : 337-463-6169
Fax Number :
Provider Business Practice Location Address
First Line : 1125 N PINE ST
Second Line :
City : DERIDDER
State : LA
Zip : 70634-2819
Country : US
Telephone Number : 337-462-2015
Fax Number : 337-462-2081
Authorized Official
Title or Position : SECRETARY/TREASURER
Name : DR. HEATHER DIMAGGIO
Credential : O.D.
Telephone Number : 337-463-6169
Provider Enumeration Date : 11/03/2009
Last Update Date : 11/03/2009

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Directions to “DIMAGGIO FAMILY EYE CARE, INC. ” Practice Location

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