Provider Demographics
NPI:1851084610
Name:LAFONT, TANNER JAMES (OD)
Entity Type:Individual
Prefix:DR
First Name:TANNER
Middle Name:JAMES
Last Name:LAFONT
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 1:16140 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70345-3666
Mailing Address - Country:US
Mailing Address - Phone:985-632-2884
Mailing Address - Fax:
Practice Address - Street 1:16140 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345-3666
Practice Address - Country:US
Practice Address - Phone:985-632-2884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2011-957AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist