Jerrold C Russell, OD - Optometrist in Columbus, WI

Jerrold C Russell, OD is a Optometrist based in Columbus, Wisconsin. Jerrold C Russell is licensed to practice in Wisconsin (license number 2029-035) and his current practice location is 1341 Park Ave, Columbus, Wisconsin. He can be reached at his office (for appointments etc.) via phone at (920) 623-2431.

NPI number for Jerrold C Russell is 1679526990 and his current mailing address is 1341 Park Ave, Columbus, Wisconsin. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1679526990.

Contact Information

Jerrold C Russell, OD
1341 Park Ave,
Columbus, WI 53925-1614
(920) 623-2431
(920) 623-3656



Healthcare Provider's Profile

Full NameJerrold C Russell
GenderMale
SpecialityOptometrist
Location1341 Park Ave, Columbus, Wisconsin
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1679526990
  • Provider Enumeration Date: 05/18/2006
  • Last Update Date: 01/22/2016

Medical Identifiers

Medical identifiers for Jerrold C Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679526990NPI-NPPES
1679526990MedicaidWI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist 2029-035 (Wisconsin)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. Jerrold C Russell 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 AddressPractice Location Address
Jerrold C Russell, OD
1341 Park Ave,
Columbus, WI 53925-1614

Ph: (920) 623-2431
Jerrold C Russell, OD
1341 Park Ave,
Columbus, WI 53925-1614

Ph: (920) 623-2431

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› Verified 7 days ago


Optometrist in Columbus, WI

Jamie L Blavat, OD
Optometrist
Medicare: Accepting Medicare Assignments
Practice Location: 1513 Park Ave Fl 1, Columbus, WI 53925
Phone: 920-623-2431    Fax: 920-623-3656

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