Provider Demographics
NPI:1275525107
Name:ZEGAR, STEVEN G (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:G
Last Name:ZEGAR
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 1:3088 GAUSE BLVD E
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-4155
Mailing Address - Country:US
Mailing Address - Phone:985-641-6464
Mailing Address - Fax:
Practice Address - Street 1:3088 GAUSE BLVD E
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4155
Practice Address - Country:US
Practice Address - Phone:985-641-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
LA758-188T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1156221Medicaid
LAT19474Medicare UPIN
LA1156221Medicaid