Provider Demographics
NPI:1265870133
Name:CONNOR, JAMES (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CONNOR
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:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70470-0061
Mailing Address - Country:US
Mailing Address - Phone:985-202-5626
Mailing Address - Fax:985-256-4840
Practice Address - Street 1:2180 N CAUSEWAY BLVD STE 10
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-6503
Practice Address - Country:US
Practice Address - Phone:985-202-5626
Practice Address - Fax:985-256-4840
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8282T152W00000X
LA1855-789AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist