Mr Raymond Wallace Iii, LPN is a
Licensed Vocational Nurse based in Mandeville, Louisiana. Mr Raymond Wallace Iii is licensed to practice in Louisiana (license number 20101002) and his current practice location is
23861 South Robin Rd, Mandeville, Louisiana. He can be reached at his office (for appointments etc.) via phone at
(985) 624-4100.
NPI number for Mr Raymond Wallace Iii is 1568821874 and his current mailing address is Po Box 37, Mandeville, Louisiana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1568821874.
Provider's Profile
Full Name | Mr Raymond Wallace Iii |
---|
Gender | Male |
---|
Speciality | Licensed Vocational Nurse |
---|
Location | 23861 South Robin Rd, Mandeville, Louisiana |
---|
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1568821874
- Provider Enumeration Date: 02/15/2016
- Last Update Date: 02/15/2016
Medical Identifiers
Medical identifiers for Mr Raymond Wallace Iii such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1568821874 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164X00000X | Licensed Vocational Nurse | 20101002 (Louisiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Raymond Wallace Iii is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Raymond Wallace Iii, LPN Po Box 37, Mandeville, LA 70470-0037 Ph: () - | Mr Raymond Wallace Iii, LPN 23861 South Robin Rd, Mandeville, LA 70448 Ph: (985) 624-4100 |
Reviews and Comments