| Vision Source | |
|
720 6th St, Evanston, WY 82930 | |
| (307) 789-1500 | |
| (307) 789-0077 |
| Full Name | Vision Source |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 720 6th St, Evanston, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700076643 | NPI | - | NPPES |
| 121954500 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 293T (Wyoming) | Primary |
| Provider Name | David R Russell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992898894 PECOS PAC ID: 9830110501 Enrollment ID: I20051212000514 |
| Mailing Address | Practice Location Address |
|---|---|
| Vision Source 916 Main St, Evanston, WY 82930-3441 Ph: (307) 789-1500 | Vision Source 720 6th St, Evanston, WY 82930 Ph: (307) 789-1500 |
Dr. William Bruce Bourland, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 701 Front St, Evanston, WY 82930 Phone: 307-789-8820 Fax: 307-789-8823 | |
Paul Robert Barnard, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 916 Main St, Evanston, WY 82930 Phone: 307-789-1500 Fax: 307-789-0077 | |
Uinta Eye And Vision Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 547 Cheyenne Dr, Evanston, WY 82930 Phone: 307-789-3937 Fax: 307-789-0797 | |
Lamont Roberson, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 125 N. 2nd Ave, Evanston, WY 82930 Phone: 307-789-9573 | |
Dr. William F Atkinson, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 547 Cheyenne Dr, Evanston, WY 82930 Phone: 307-789-3937 Fax: 307-789-0797 | |
William Bruce Bourland Od Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 701 Front St, Evanston, WY 82930 Phone: 307-789-8820 |