Dr Gary Wayne Wallace, MD | |
2295 Coronado Street, Idaho Falls, ID 83404 | |
(208) 524-8600 | |
(208) 524-8394 |
Full Name | Dr Gary Wayne Wallace |
---|---|
Gender | Male |
Speciality | Ophthalmology |
Experience | 31 Years |
Location | 2295 Coronado Street, Idaho Falls, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144335290 | NPI | - | NPPES |
000010001884 | Other | ID | REGENCE BLUE SHIELD |
002797900 | Medicaid | ID | |
J4449 | Other | ID | BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | M-6226 (Idaho) | Primary |
Entity Name | Center For Sight Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861567919 PECOS PAC ID: 7719891209 Enrollment ID: O20031118000893 |
Mailing Address | Practice Location Address |
---|---|
Dr Gary Wayne Wallace, MD 2295 Coronado Street, Idaho Falls, ID 83404 Ph: (208) 524-8600 | Dr Gary Wayne Wallace, MD 2295 Coronado Street, Idaho Falls, ID 83404 Ph: (208) 524-8600 |
Matthew P Traynor, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 2100 Providence Way, Idaho Falls, ID 83404 Phone: 208-529-6600 Fax: 208-529-6602 | |
Dr. Kenneth W Turley, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 2025 E 17th St, Idaho Falls, ID 83404 Phone: 208-524-2025 Fax: 208-529-1924 | |
David Ray Anderson, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 530 S Holmes, Idaho Falls, ID 83403 Phone: 208-529-3937 Fax: 208-524-4380 | |
Dr. Bradley P Gardner, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 2025 E 17th St, Idaho Falls, ID 83404 Phone: 208-524-2025 Fax: 208-529-1924 | |
Mr. Peter Carl Zimmerman, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 1449 E 17th Street, Idaho Falls, ID 83404 Phone: 208-529-6600 Fax: 208-529-6603 | |
Dr. Clinton Ellingson, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 2100 Providence Way, Idaho Falls, ID 83404 Phone: 208-529-6600 Fax: 208-529-6602 |