Mr Raymond Wallace Iii, LPN in Mandeville, LA - Licensed Vocational Nurse

Mr Raymond Wallace Iii, LPN is a Licensed Vocational Nurse based in Mandeville, Louisiana. Mr Raymond Wallace Iii is licensed to practice in Louisiana (license number 20101002) and his current practice location is 23861 South Robin Rd, Mandeville, Louisiana. He can be reached at his office (for appointments etc.) via phone at (985) 624-4100.

NPI number for Mr Raymond Wallace Iii is 1568821874 and his current mailing address is Po Box 37, Mandeville, Louisiana. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1568821874.

Contact Information

	Mr Raymond Wallace Iii, LPN
	23861 South Robin Rd, Mandeville, LA 70448
	(985) 624-4100
	Not Available

Provider's Profile

Full Name	Mr Raymond Wallace Iii
Gender	Male
Speciality	Licensed Vocational Nurse
Location	23861 South Robin Rd, Mandeville, Louisiana
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1568821874
Provider Enumeration Date: 02/15/2016
Last Update Date: 02/15/2016

Medical Identifiers

Medical identifiers for Mr Raymond Wallace Iii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1568821874	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
164X00000X	Licensed Vocational Nurse	20101002 (Louisiana)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Raymond Wallace Iii is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Raymond Wallace Iii, LPN Po Box 37, Mandeville, LA 70470-0037 Ph: () -	Mr Raymond Wallace Iii, LPN 23861 South Robin Rd, Mandeville, LA 70448 Ph: (985) 624-4100

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Mr Raymond Wallace Iii, LPN - Licensed Vocational Nurse in Mandeville, LA