Organization
M. DWAYNE YEAGER, OD, FAAO, A PROFESSIONAL ORGANIZATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
M DWAYNE YEAGER OD (OPTOMETRIST)
(318) 325-3937
Entity
Organization
Contact information
Practice address
3805 CYPRESS ST, WEST MONROE, LA 71291-7436
(318) 325-3937
(318) 397-9717
Mailing address
3805 CYPRESS ST, WEST MONROE, LA 71291-7436
(318) 325-3937
(318) 397-9717
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
1020-199T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1369004
—
LA
Enumeration date
11/02/2010
Last updated
12/09/2010
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