Provider Demographics
NPI:1346475530
Name:CHILDREN'S EYE CENTER, L.L.C.
Entity Type:Organization
Organization Name:CHILDREN'S EYE CENTER, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:OLAF
Authorized Official - Last Name:SESSUMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-767-2099
Mailing Address - Street 1:8080 BLUEBONNET BLVD
Mailing Address - Street 2:STE 2020
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-7827
Mailing Address - Country:US
Mailing Address - Phone:225-767-2099
Mailing Address - Fax:225-767-1881
Practice Address - Street 1:8080 BLUEBONNET BLVD
Practice Address - Street 2:STE 2020
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-7827
Practice Address - Country:US
Practice Address - Phone:225-767-2099
Practice Address - Fax:225-767-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017188207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B65329Medicare UPIN