Provider Demographics
NPI:1184756660
Name:KING, DENISE FLETCHER (OD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:FLETCHER
Last Name:KING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 N HIGHWAY 190
Mailing Address - Street 2:VISION CARE PLUS
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-5178
Mailing Address - Country:US
Mailing Address - Phone:985-893-2020
Mailing Address - Fax:985-893-1675
Practice Address - Street 1:1124 N HIGHWAY 190
Practice Address - Street 2:VISION CARE PLUS
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-5178
Practice Address - Country:US
Practice Address - Phone:985-893-2020
Practice Address - Fax:985-893-1675
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA994-232T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1354244Medicaid
LA1354244Medicaid
LAT19511Medicare UPIN