| |
5118 Park Ave, Suite101, Memphis, TN 38117 | |
(901) 683-4529 | |
(901) 767-4404 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 5118 Park Ave, Memphis, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659559490 | NPI | - | NPPES |
1639481906 | Other | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Tennessee) | Primary |
Provider Name | Landon Jay Wallace |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1639481906 PECOS PAC ID: 0547498081 Enrollment ID: I20140108001576 |
Mailing Address | Practice Location Address |
---|---|
5118 Park Ave, Suite101, Memphis, TN 38117-5720 Ph: (901) 683-4529 | 5118 Park Ave, Suite101, Memphis, TN 38117 Ph: (901) 683-4529 |
Dr. Seth Aaron Salley, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 618 Oakleaf Office Ln Ste 100, Memphis, TN 38117 Phone: 901-821-8337 Fax: 901-379-8297 | |
Dr. Carrie Tobin Irvine, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1714 W Massey Rd, Memphis, TN 38120 Phone: 901-685-5520 Fax: 901-685-0782 | |
Shaleen Ragha, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1030 Jefferson Ave, Memphis, TN 38104 Phone: 901-523-8990 | |
Dr. Azalia Rochelle Roach, OD Optometrist Medicare: Medicare Enrolled Practice Location: 1245 Madison Ave, Memphis, TN 38104 Phone: 901-722-3200 | |
Dr. Daniel Gunn Fuller, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1225 Madison Ave, Memphis, TN 38104 Phone: 901-722-3319 Fax: 901-722-3394 | |
Dr. Michael T Christensen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1225 Madison Ave, Memphis, TN 38104 Phone: 901-722-3250 Fax: 901-722-3247 |