# W E MARIONNEAUX JR OD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205028057
- **Authorized official:** MR. WILLARD E MARIONNEAUX JR. OD (OPTOMETRIST OWNER)
- **Authorized official phone:** (318) 435-5145

## Contact information

- **Practice address:** 6609 MAIN ST, WINNSBORO, LA 71295-2763
- **Practice address phone:** (318) 435-5145
- **Practice address fax:** (318) 435-9476
- **Mailing address:** PO BOX 910, WINNSBORO, LA 71295-0910
- **Mailing address phone:** (318) 435-5145
- **Mailing address fax:** (318) 435-9476

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 712 014 T | LA | Yes |

## Other

- **Enumeration date:** 08/15/2007
- **Last updated:** 01/28/2008