Landon Jay Wallace (NPI# 1639481906, PAC ID# 0547498081) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1639481906 |
| PAC ID by PECOS | 0547498081 |
| Professional Enrollment ID | I20140108001576 |
| Full Name | Landon Jay Wallace |
| Address |
5118 Park Ave Suite 101 Memphis TN 38117-5710 |
| Gender | M |
| Medical School | SOUTHERN COLLEGE OF OPTOMETRY |
| Graduation Year | 2010 |
| Primary Specialty | OPTOMETRY |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 5118 Park Ave, Suite 101, Memphis, TN 38117-5710 |
| Street Address |
5118 PARK AVE SUITE 101 |
| City | MEMPHIS |
| State | TN |
| Zip | 38117-5710 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John T Lee | Optometry | East Memphis Optometry Pa | 5118 Park Ave, Suite 101, Memphis, TN 38117-5710 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mohammed Moinuddin | Internal Medicine | Jnt Medical Lc | 721 W Brookhaven /circle, Memphis, TN 38117 |
| Erica R. Grant Ervin | Nurse Practitioner | Cgand T | 721 W Brokhaven Cir, Memphis, TN 38117 |
| Hillary H Hunt | Internal Medicine | Baptist Minor Medical Centers Inc | 7424 Us Hwy 64, Suite 111, Memphis, TN 38117 |
| John C Wood | Internal Medicine | Jnt Medical Lc | 721 W Brookhaven /circle, Memphis, TN 38117 |
| Christopher J Cummins | Family Medicine | Jnt Medical Lc | 721 W Brookhaven /circle, Memphis, TN 38117 |
| April R Epps-carter | Nurse Practitioner | Cgand T | 721 W Brokhaven Cir, Memphis, TN 38117 |
| John W Fowler Jr. | Internal Medicine | 184 Colonial Rd, Memphis, TN 38117-3206 | |
| Warren S Johnson | Optometry | Professional Eyecare Optical | 428 Perkins Extd, Memphis, TN 38117-3802 |
| Do Nguyen | Optometry | Professional Eyecare Optical | 428 Perkins Extd, Memphis, TN 38117-3802 |
| John Engbretson | Family Medicine | Saint Francis Physician Network, LLC | 452 Perkins Ext, Memphis, TN 38117-3808 |
| Find all physicians in zip 38117 | |||
| City | MEMPHIS |
| Zip Code | 38117 |
| Specialty | OPTOMETRY |
| City + Specialty | MEMPHIS + OPTOMETRY |
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| 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.