DR. MICHAEL WADE JORGENSEN OD LLC (NPI# 1144677899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144677899 |
| Entity Type | Organization |
| Organization Name | DR. MICHAEL WADE JORGENSEN OD LLC |
| Practice Address |
187 Burt Blvd Ste A Benton LA 71006-4905 |
| Practice Telephone | 3189355080 |
| Practice Fax Number | 3189355085 |
| Mailing Telephone | 3189355080 |
| Mailing Fax Number | 3189355085 |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-05-23 |
| Authorized Official Name | DR. MICHAEL WADE JORGENSEN (OWNER/DOCTOR) |
| Authorized Official Telephone | 3189355080 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1590623T | LA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2394495 | 05 |
| Street Address |
187 BURT BLVD STE A |
| City | BENTON |
| State | LA |
| Zip Code | 71006-4905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558675157 | Michael Wade Jorgensen | Optometrist | 187 Burt Blvd, Ste A, Benton, LA 71006-4905 | 2010-08-06 |
| 1558718205 | Vista Vision LLC | Eyewear Supplier (Equipment, not the service) | 187 Burt Blvd, Ste A, Benton, LA 71006-4905 | 2016-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450517 | Just Health | Clinic/Center | 7076 La-3, Benton, LA 71006 | 2020-06-02 |
| 1982819678 | Robert Carroll Denmon | Pharmacist | 5604 Hwy 3, Freds Pharmacy # 1534, Benton, LA 71006 | 2007-05-14 |
| 1326174202 | David W Loftin | Pharmacist | 5604 Benton Rd, Benton, LA 71006 | 2007-02-26 |
| 1720163587 | Wayne Holden Marionneaux | Dentist | 192 Burt Blvd, Bentone, LA 71006 | 2006-10-27 |
| 1558478925 | Freds Stores of Tennessee Inc | Pharmacy | 5604 Hwy 3, Benton, LA 71006 | 2006-08-23 |
| 1861404683 | Rolling Rehab LLC | Physical Therapist | 115 Hunt Rd, Benton, LA 71006-3469 | 2006-08-12 |
| 1932327608 | Shanna D. Johnson | Physical Therapist | 115 Hunt Rd, Benton, LA 71006-3469 | 2007-04-20 |
| 1194134452 | Margaret B Rutledge | Social Worker | 2018 Pine Ridge Way, Benton, LA 71006-3488 | 2014-08-11 |
| 1942373410 | Brookshire Grocery Company | Pharmacy | 6280 Highway 3, Attention Pharmacy Dept, Benton, LA 71006-3492 | 2006-11-15 |
| 1669854253 | Dao B Kha | Pharmacist | 6280 Highway 3, Benton, LA 71006-3492 | 2015-06-19 |
| Find all providers in zip 71006 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801340633 | Cvo-bryant, LLC | Optometrist | 20770 I 30, Suite 135, Benton, AR 72019-8022 | 2016-08-10 |
| 1437402609 | Contact Lens Express LLC | Optometrist | 3715 Wildflower Ln, Benton, AR 72015-9000 | 2012-10-24 |
| 1033407226 | David Bryon Glenn | Optometrist | 443 Hwy 5 N, Benton, AR 72019-9778 | 2011-07-21 |
| 1356635510 | Justin B. Franks O.d. P.a. | Optometrist | 3016 Castle Valley Dr, Benton, AR 72019-6976 | 2011-06-06 |
| 1558675157 | Michael Wade Jorgensen | Optometrist | 187 Burt Blvd, Ste A, Benton, LA 71006-4905 | 2010-08-06 |
| 1528371150 | Jamie Byron Johnson | Optometrist | 318 W Sevier St, Benton, AR 72015-4270 | 2010-07-25 |
| 1124257035 | Natasha G. Lyles | Optometrist | 140 Commerce Blvd, Benton, KY 42025-1112 | 2009-07-13 |
| 1669651311 | Benton Eyecare Clinic | Optometrist | 443 Highway 5 N, Benton, AR 72019-9778 | 2007-10-30 |
| 1801839477 | Michael Lynn Hayes | Optometrist | 310 W 5th St, Benton, KY 42025-1102 | 2006-06-13 |
| 1245204304 | Laurel Morris | Optometrist | 109 W 5th St, Benton, KY 42025-1123 | 2006-02-15 |
| Find all providers in BENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.