| Dr. Michael Wade Jorgensen Od Llc | |
|
187 Burt Blvd, Ste A, Benton, LA 71006-4905 | |
| (318) 935-5080 | |
| (318) 935-5085 |
| Full Name | Dr. Michael Wade Jorgensen Od Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 187 Burt Blvd, Benton, Louisiana |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144677899 | NPI | - | NPPES |
| 2394495 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 1590623T (Louisiana) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Michael Wade Jorgensen Od Llc 187 Burt Blvd, Ste A, Benton, LA 71006-4905 Ph: (318) 935-5080 | Dr. Michael Wade Jorgensen Od Llc 187 Burt Blvd, Ste A, Benton, LA 71006-4905 Ph: (318) 935-5080 |
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› Verified 9 days ago
Dr. Michael Wade Jorgensen, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 187 Burt Blvd, Ste A, Benton, LA 71006 Phone: 318-935-5080 Fax: 318-935-5085 |