Provider Demographics
NPI:1285657296
Name:GILL, STEVE D (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:D
Last Name:GILL
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 1:1407 SWEET BAY CT
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-5085
Mailing Address - Country:US
Mailing Address - Phone:866-264-1898
Mailing Address - Fax:
Practice Address - Street 1:2820 NAPOLEON AVE
Practice Address - Street 2:SUITE 750
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-412-1210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA970-277T152WC0802X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1341606Medicaid
LAP00774306OtherRAILROAD MEDICARE PART B
LA49720F670Medicare PIN
LA49720F668Medicare PIN
LAP00774306OtherRAILROAD MEDICARE PART B
LA1341606Medicaid
LA49720F669Medicare PIN