# MR. WILLARD E MARIONNEAUX JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1407917891
- **Gender:** Man
- **Credential:** OD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 712014T | LA | Yes |

## Other

- **Enumeration date:** 12/12/2006
- **Last updated:** 08/20/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1117307 | — | LA |
| 01 | — | 5388880001 | PALMETTO | — |