Russell Wardlaw (NPI# 1376734210, PAC ID# 3971691643) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GASTROENTEROLOGY.
| Nation Provider ID (NPI) | 1376734210 |
| PAC ID by PECOS | 3971691643 |
| Professional Enrollment ID | I20080320000220 |
| Full Name | Russell Wardlaw |
| Organization Legal Name | NORTHLAKE GASTROENTEROLOGY |
| Address |
7015 Hwy 190 E Service Rd Suite 102 Covington LA 70433-4960 |
| Phone Number | 9855421334 |
| Gender | M |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
| Graduation Year | 2002 |
| Primary Specialty | GASTROENTEROLOGY |
| Group Practice PAC ID | 9234197419 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190176 | TULANE MEDICAL CENTER |
| 190045 | ST TAMMANY PARISH HOSPITAL |
| 190267 | FAIRWAY MEDICAL CENTER |
| 190015 | NORTH OAKS MEDICAL CENTER, L L C |
| 190040 | SLIDELL MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 7015 Hwy 190 E Service Rd, Suite 102, Covington, LA 70433-4960 | 9855421334 | NORTHLAKE GASTROENTEROLOGY |
| Organization Legal Name | NORTHLAKE GASTROENTEROLOGY |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gregory Mark Mula | Gastroenterology | Northlake Gastroenterology | 16061 Doctors Blvd B, Hammond, LA 70403-1499 |
| Dennis J. Booth Jr. | Gastroenterology | Northlake Gastroenterology | 16061 Doctors Blvd B, Hammond, LA 70403-1499 |
| Lawrence L Gensler | Gastroenterology | Northlake Gastroenterology | 7015 Hwy 190 E Service Rd, Suite 102, Covington, LA 70433-4960 |
| Jason B Reina | Gastroenterology | Northlake Gastroenterology | 16061 Doctors Blvd B, Hammond, LA 70403-1499 |
| Street Address |
7015 HWY 190 E SERVICE RD SUITE 102 |
| City | COVINGTON |
| State | LA |
| Zip | 70433-4960 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura M Boyer | Nurse Practitioner | Surgical Specialists of La | 7015 Hwy 190 E Service Rd, Suite 200, Covington, LA 70483-4960 |
| Lisa M Jaubert-miazza | Physical Medicine and Rehabilitation | Northshore Interventional Pain Management, Apmc | 7015 Hwy 190 E Service Rd, Suite 101, Covington, LA 70433-4960 |
| Allan T Parr | Interventional Pain Management | Northshore Interventional Pain Management, Apmc | 7015 Hwy 190 E Service Rd, Suite 101, Covington, LA 70433-4960 |
| Jill K Hurley | Occupational Therapy | 7015 Hwy 190 E Service Rd, Suite 103, Covington, LA 70433-4960 | |
| Monika L Bowden | Certified Registered Nurse Anesthetist (crna) | Northshore Interventional Pain Management, Apmc | 7015 Hwy 190 E Service Rd, Suite 101, Covington, LA 70433-4960 |
| Clark G Warden | General Surgery | Surgical Specialists of La | 7015 Hwy 190 E Service Rd, Suite 200, Covington, LA 70483-4960 |
| Lawrence L Gensler | Gastroenterology | Northlake Gastroenterology | 7015 Hwy 190 E Service Rd, Suite 102, Covington, LA 70433-4960 |
| Stephanie C Ryan | Nurse Practitioner | Surgical Specialists of La | 7015 Hwy 190 E Service Rd, Suite 200, Covington, LA 70483-4960 |
| Nadia L Johnson | Occupational Therapy | Hhl Therapy Centers LLC | 7015 Hwy 190 E Service Rd, Suite 103, Covington, LA 70433-4960 |
| Dolly B Smith | Occupational Therapy | Hhl Therapy Centers LLC | 7015 Hwy 190 E Service Rd, Suite 103, Covington, LA 70433-4960 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cindy Pechon | Clinical Social Worker | 5001 U S Hwy 190 D4, Covington, LA 70433 | |
| Richard B Drude | Gastroenterology | Richard B. Drude, Jr., M.d., Apmc | 69150 Hwy 190, Covington, LA 70433 |
| Bruce S Samuels | Internal Medicine | 189 Greenbriar Blvd, Suite C, Covington, LA 70433 | |
| Nicholas J Viviano | Dermatology | 7031 Hwy 190, Covington, LA 70433 | |
| Thomas W Nielsen Jr. | Clinical Social Worker | 5001 Hwy 190, Suite B 1, Covington, LA 70433 | |
| Glenn D Hedgpeth | Gastroenterology | Dr. Bruce S. Samuels, LLC | 189 Greenbriar Blvd, Covington, LA 70433 |
| Brian C Cochran | Physical Therapy | Covington Physical Therapy Center | 129 Corporate Dr, Covington, LA 70433-1057 |
| Jonathan S Mitchell | Physical Therapy | Covington Physical Therapy Center | 129 Corporate Dr, Covington, LA 70433-1057 |
| Charles Balette | Family Medicine | 1119 S Tyler St, Covington, LA 70433-2327 | |
| Roy C Saguiguit | Internal Medicine | 1113 S Tyler St, Covington, LA 70433-2327 | |
| Find all physicians in zip 70433 | |||
| City | COVINGTON |
| Zip Code | 70433 |
| Specialty | GASTROENTEROLOGY |
| City + Specialty | COVINGTON + GASTROENTEROLOGY |
Please comment or provide details below to improve the information on Russell Wardlaw.
| 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.