MEDICARE: OLIVER WENDALL WHITNEY A PROFESSIONAL OPTOMETRY CORP (APOC)

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
1	152W00000X	Optometrist	810300	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821223231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLIVER WENDALL WHITNEY A PROFESSIONAL OPTOMETRY CORP (APOC)

Provider Business Mailing Address
First Line	:	PO BOX 879
Second Line	:
City	:	MANDEVILLE
State	:	LA
Zip	:	70470-0879
Country	:	US
Telephone Number	:	985-626-5242
Fax Number	:

Provider Business Practice Location Address
First Line	:	1580 W CAUSEWAY APPROACH
Second Line	:	SUITE 3
City	:	MANDEVILLE
State	:	LA
Zip	:	70471-3033
Country	:	US
Telephone Number	:	985-626-5242
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. OLIVER WENDELL WHITNEY
Credential	:	O.D.
Telephone Number	:	985-626-5242

Provider Enumeration Date	:	05/29/2009
Last Update Date	:	01/25/2011

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