Provider Demographics
NPI:1700882917
Name:PICCIONE, RICHARD JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAMES
Last Name:PICCIONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4906 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:STE. 701 - BLDG G
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6916
Mailing Address - Country:US
Mailing Address - Phone:337-989-2600
Mailing Address - Fax:337-989-2601
Practice Address - Street 1:4906 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:STE. 701 BLDG G
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6916
Practice Address - Country:US
Practice Address - Phone:337-989-2600
Practice Address - Fax:337-989-2601
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.09888R207WX0110X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1695068Medicaid
5Y455Medicare PIN
LA1695068Medicaid