Provider Demographics
NPI:1194140285
Name:GREATER NEW ORLEANS EYE CARE LLC
Entity type:Organization
Organization Name:GREATER NEW ORLEANS EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:WILHITE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:615-653-8663
Mailing Address - Street 1:1670 BARATARIA BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-4354
Mailing Address - Country:US
Mailing Address - Phone:504-348-2993
Mailing Address - Fax:504-340-4468
Practice Address - Street 1:1670 BARATARIA BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-4354
Practice Address - Country:US
Practice Address - Phone:504-348-2993
Practice Address - Fax:504-340-4468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1635-669T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA389005Medicare PIN