Provider Demographics
NPI:1760453625
Name:WILBUR, ERNEST ARTHUR III (OD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:ARTHUR
Last Name:WILBUR
Suffix:III
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:2901 GENERAL DE GAULLE DR
Mailing Address - Street 2:STE 101
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114
Mailing Address - Country:US
Mailing Address - Phone:504-368-5320
Mailing Address - Fax:504-366-4961
Practice Address - Street 1:2901 GENERAL DE GAULLE DR
Practice Address - Street 2:STE 101
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114
Practice Address - Country:US
Practice Address - Phone:504-368-5320
Practice Address - Fax:504-366-4961
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2007-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA811167T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1397407Medicaid
LA1397407Medicaid
49340Medicare PIN