Provider Demographics
NPI:1902919913
Name:WROTEN, CHRISTOPHER WAYNE (OD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WAYNE
Last Name:WROTEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 S MORRISON BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-5737
Mailing Address - Country:US
Mailing Address - Phone:985-345-2020
Mailing Address - Fax:985-345-2430
Practice Address - Street 1:1705 S MORRISON BLVD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5737
Practice Address - Country:US
Practice Address - Phone:985-345-2020
Practice Address - Fax:985-345-2430
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1400-536T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1737666Medicaid
LA1737666Medicaid
LAU95587Medicare UPIN