Organization
SHENANDOAH EYE CLINIC
Active
Other names
The Lens Source
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN F ADAMS III OD (OPTOMETRIST/OWNER/CEO)
(225) 755-3937
Entity
Organization
Contact information
Practice address
5237 JONES CREEK ROAD, BATON ROUGE, LA 70817-2124
(225) 755-3937
(225) 755-2272
Mailing address
5237 JONES CREEK ROAD, BATON ROUGE, LA 70817-2124
(225) 755-3937
(225) 755-2272
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WS0006X
Sports Vision Optometrist
—
—
332H00000X
Eyewear Supplier
Primary
LA773206T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0699540001
MEDICARE SUPPLIER #
LA
05
—
1196519
—
LA
Enumeration date
05/16/2006
Last updated
07/09/2014
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