Russell W Tynes (NPI# 1851323810, PAC ID# 0446347579) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1851323810 |
| PAC ID by PECOS | 0446347579 |
| Professional Enrollment ID | I20071106000319 |
| Full Name | Russell W Tynes |
| Address |
460 Ashley Ridge Blvd Suite 500 Shreveport LA 71106-7238 |
| Gender | M |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT |
| Graduation Year | 1982 |
| Primary Specialty | INTERNAL MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190111 | WILLIS KNIGHTON MEDICAL CENTER |
| 190041 | CHRISTUS HEALTH SHREVEPORT - BOSSIER |
| Address | Phone | Organization |
|---|---|---|
| 460 Ashley Ridge Blvd, Suite 500, Shreveport, LA 71106-7238 |
| Street Address |
460 ASHLEY RIDGE BLVD SUITE 500 |
| City | SHREVEPORT |
| State | LA |
| Zip | 71106-7238 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Trent M Andre | Physical Therapy | Core Physical Therapy and Performance LLC | 460 Ashley Ridge Blvd, Suite 800, Shreveport, LA 71106-7238 |
| Catherine F Vanderloos | Obstetrics/gynecology | 460 Ashley Ridge Blvd, Suite 200, Shreveport, LA 71106-7236 | |
| Brennan A Bernard | Physical Therapy | Core Physical Therapy and Performance LLC | 460 Ashley Ridge Blvd, Suite 800, Shreveport, LA 71106-7238 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kamal A Masri | Internal Medicine | 3801 Creswell Ave, Unit 19, Shreveport, LA 71106-1257 | |
| Michael D Pickering | Optometry | Eye Care, Inc | 5848 Line Ave, Shreveport, LA 71106-1532 |
| Carla Carter | Optometry | Eye Care, Inc | 5848 Line Ave, Shreveport, LA 71106-1532 |
| Jessica K Lantz | Optometry | Eye Care, Inc | 5848 Line Ave, Shreveport, LA 71106-1532 |
| Robert Newton Schwendimann | Neurology | Remote Neuromonitoring Physicians PC | 751 Oneonta St, Shreveport, LA 71106-1623 |
| Kelly A Yerger | Nurse Practitioner | 910 Pierremont Rd, Suite 234, Shreveport, LA 71106-2058 | |
| Lindsey A Pennington | Otolaryngology | 6030 Line Ave, Suite 110, Shreveport, LA 71106-2073 | |
| Tiffany A Jennings | Psychologist, Clinical | 920 Pierremont Rd, Suite 205, Shreveport, LA 71106-2093 | |
| Brandy Morgan Stroud | Clinical Social Worker | Interactional Services, Inc | 707 Southfield Rd, Shreveport, LA 71106-2219 |
| Linda I Grayson | Clinical Social Worker | Interactional Services, Inc | 707 Southfield Rd, Shreveport, LA 71106-2219 |
| Find all physicians in zip 71106 | |||
| City | SHREVEPORT |
| Zip Code | 71106 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | SHREVEPORT + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Russell W Tynes.
| 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.