Provider Demographics
NPI:1295369817
Name:ALLEMOND AND JELKS LLC
Entity Type:Organization
Organization Name:ALLEMOND AND JELKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRADFORD
Authorized Official - Last Name:JELKS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:601-341-1931
Mailing Address - Street 1:4263 HWY 1 S
Mailing Address - Street 2:
Mailing Address - City:PORT ALLEN
Mailing Address - State:LA
Mailing Address - Zip Code:70767-5824
Mailing Address - Country:US
Mailing Address - Phone:225-308-6311
Mailing Address - Fax:225-490-4969
Practice Address - Street 1:4263 HWY 1 S
Practice Address - Street 2:
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767-5824
Practice Address - Country:US
Practice Address - Phone:225-308-6311
Practice Address - Fax:225-490-4969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty