EDDIE DALE MCCLURE (NPI# 1750662474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750662474 |
| Entity Type | Individual |
| Full Name | EDDIE DALE MCCLURE |
| Credential | OPTICIAN |
| Practice Address |
5368 Kennesaw Dr Baton Rouge LA 70817-2555 |
| Mailing Address |
3153 E Texas St Bossier City LA 71111-3209 |
| Practice Telephone | 2257530441 |
| Practice Fax Number | 2257533320 |
| Mailing Telephone | 2257530441 |
| Mailing Fax Number | 2257533320 |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2011-09-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
10-00013656 | LA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1156612 | 05 | |
| LA | MEDICAID NPI NUMBER | 1508876095 | 01 |
| Street Address |
5368 KENNESAW DR |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70817-2555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518503754 | Optimus Primary Care, LLC | Clinic/Center | 13828 Coursey Boulevard, Address Line 2, Baton Rouge, LA 70817 | 2019-11-22 |
| 1457821043 | Traci Bellazin | Case Manager/Care Coordinator | 9334 Falling Oak Dr., Baton Rouge, LA 70817 | 2018-11-27 |
| 1124502869 | Jacob Schrieffer | Nurse Practitioner | 15389 Airline Highway, Baton Rouge, LA 70817 | 2018-09-19 |
| 1629564638 | Baton Rouge Dental Associates, LLC | Dentist | 14948 Market St, Baton Rouge, LA 70817 | 2018-07-03 |
| 1740786946 | Charlotte L Watts | Nurse Practitioner | 15389 Airline Hwy, Baton Rouge, LA 70817 | 2018-04-05 |
| 1164957536 | Deranecha Francois | Counselor | 17232 Jefferson Hwy, Apt 121, Baton Rouge, LA 70817 | 2017-04-24 |
| 1992251573 | Jacob Dent, Dds. Baton Rouge Modern Dentistry, A Professional Corp | Dentist | 14640 Village Market St, Suite 103, Baton Rouge, LA 70817 | 2016-09-01 |
| 1235522962 | Cardinal Community Services LLC | Clinic/Center | 13702 Coursey Blvd. Bldg 6 Ste A 2, Baton Rouge, LA 70817 | 2015-03-05 |
| 1962832204 | Bcbr Facility Services, LLC | Clinic/Center | 277 Rue De La Vie, Baton Rouge, LA 70817 | 2013-11-23 |
| 1700225737 | Renee Denise Beyer Boudreaux | Nurse Practitioner | 500 Rue De La Vie, Suite 401, Baton Rouge, LA 70817 | 2013-06-24 |
| Find all providers in zip 70817 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336633528 | Cherie Lewis | Technician/Technologist | 257 Lee Dr Ste B, Baton Rouge, LA 70808-4977 | 2018-06-20 |
| 1760926935 | Smarter Eyewear LLC | Technician/Technologist | 3535 Perkins Rd Ste 330, Baton Rouge, LA 70808-2292 | 2016-12-07 |
| 1881026110 | John Olan Cook | Technician/Technologist | 3535 Perkins Rd, Suite 330, Baton Rouge, LA 70808-2262 | 2013-08-09 |
| 1619021375 | Ashley Monique Waters | Technician/Technologist | 12278 Plank Road, Baton Rouge, LA 70811 | 2007-01-22 |
| 1629621388 | Nam Nguyen | Technician/Technologist | 3535 Perkins Rd Ste 330, Baton Rouge, LA 70808-2292 | 2019-07-22 |
| 1821415779 | Wal-mart Stores East, Lp | Technician/Technologist | 10550 Burbank Dr, Baton Rouge, LA 70810-6468 | 2014-03-27 |
| 1740493089 | Eye Specialsits Eyewear,llc | Technician/Technologist | 7777 Hennessy Blvd, Suite 5000, Baton Rouge, LA 70808-4300 | 2007-05-07 |
| 1831234673 | Elite Eyewear, Inc | Technician/Technologist | 4848 North Blvd, Baton Rouge, LA 70806-4019 | 2007-02-20 |
| 1669550018 | Wal-mart Stores Louisiana, LLC | Technician/Technologist | 3132 College Dr, Baton Rouge, LA 70808-3119 | 2006-11-02 |
| 1831277292 | Wal-mart Stores Louisiana, LLC | Technician/Technologist | 2171 Oneal Ln, Baton Rouge, LA 70816-3206 | 2006-11-02 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70817 |
Please comment or provide details below to improve the information on EDDIE DALE MCCLURE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.