Russell H Vannorman (NPI# 1679576961, PAC ID# 5890755508) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPHTHALMOLOGY.
| Nation Provider ID (NPI) | 1679576961 |
| PAC ID by PECOS | 5890755508 |
| Professional Enrollment ID | I20041018000273 |
| Full Name | Russell H Vannorman |
| Organization Legal Name | WALLACE EYE SURGERY, LTD |
| Address |
4300 Parliament Dr Alexandria LA 71303-2721 |
| Phone Number | 3184480221 |
| Gender | M |
| Credential | MD |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT |
| Graduation Year | 1998 |
| Primary Specialty | OPHTHALMOLOGY |
| Group Practice PAC ID | 0042240210 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190111 | WILLIS KNIGHTON MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 4300 Parliament Dr, Alexandria, LA 71303-2721 | 3184480221 | WALLACE EYE SURGERY, LTD |
| 1801 Fairfield Ave, Suite 207, Shreveport, LA 71101-4460 | 3182054964 | SHREVEPORT EYE SPECIALISTS, LLC |
| Organization Legal Name | WALLACE EYE SURGERY, LTD |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Phillip L Carney Jr. | Optometry | Wallace Eye Surgery, Ltd | 4300 Parliament Dr, Alexandria, LA 71303-2721 |
| Robert B Wallace | Ophthalmology | Wallace Eye Surgery, Ltd | 4300 Parliament Dr, Alexandria, LA 71303-2721 |
| Robert Theus Crotty | Optometry | Wallace Eye Surgery, Ltd | 4300 Parliament Dr, Alexandria, LA 71303-2721 |
| Street Address |
4300 PARLIAMENT DR |
| City | ALEXANDRIA |
| State | LA |
| Zip | 71303-2721 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Phillip L Carney Jr. | Optometry | Wallace Eye Surgery, Ltd | 4300 Parliament Dr, Alexandria, LA 71303-2721 |
| Robert B Wallace | Ophthalmology | Wallace Eye Surgery, Ltd | 4300 Parliament Dr, Alexandria, LA 71303-2721 |
| Robert Theus Crotty | Optometry | Wallace Eye Surgery, Ltd | 4300 Parliament Dr, Alexandria, LA 71303-2721 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cornel H Leblanc | Optometry | Visual Care and Contact Lens Clinic Inc | 5917 Jackson St Ext, Alexandria, LA 71303-2048 |
| Stephen M Leblanc | Optometry | Visual Care and Contact Lens Clinic Inc | 5917 Jackson St Ext, Alexandria, LA 71303-2048 |
| Lacy B Shaw | Optometry | 5615 -b Jackson St Ext, Alexandria, LA 71303-2275 | |
| James W Quillin | Psychologist, Clinical | James W Quillin, Phd, Appc | 1016 Calais Cir, Alexandria, LA 71303-2307 |
| Lauren D Stokes | Psychologist, Clinical | James W Quillin, Phd, Appc | 1016 Calais Cir, Alexandria, LA 71303-2307 |
| Jennifer Q Andrus | Clinical Social Worker | James W Quillin, Phd, Appc | 1016 Calais Cir, Alexandria, LA 71303-2307 |
| Conrad Martin Taylor | Chiropractic | Mayfield Advanced Medical LLC | 5419 Jackson St, Suite B, Alexandria, LA 71303-2322 |
| Robert C Smith | General Surgery | 5417 Jackson St Ext, Alexandria, LA 71303-2322 | |
| Kirsten Van Mol | Nurse Practitioner | Mayfield Advanced Medical LLC | 5419 Jackson St, Suite B, Alexandria, LA 71303-2322 |
| Ryan J Knoll | Chiropractic | Mayfield Advanced Medical LLC | 5419 Jackson St, Suite B, Alexandria, LA 71303-2322 |
| Find all physicians in zip 71303 | |||
| City | ALEXANDRIA |
| Zip Code | 71303 |
| Specialty | OPHTHALMOLOGY |
| City + Specialty | ALEXANDRIA + OPHTHALMOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.