| Richard Anthony Wallace, CRNA | |
|
8045 Roane Medical Center Dr, Harriman, TN 37748-8333 | |
| (865) 316-1000 | |
| Not Available |
| Full Name | Richard Anthony Wallace |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 8045 Roane Medical Center Dr, Harriman, Tennessee |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629031992 | NPI | - | NPPES |
| 0454102553 | Other | TN | TRICARE SOUTH HUMANA MILITARY |
| 4317478 | Other | TN | BCBS - COVER TENNESSEE |
| 4317478 | Other | TN | BCBS - MEDICARE ADVANTAGE (BLUEADVANTAGE) |
| 616644300 | Other | TN | DEPT OF LABOR WORKER'S COMP - DEEOIC PROGRAM |
| 171975592453 | Other | TN | HUMANA |
| 4317478 | Other | TN | BCBS - BLUE SELECT |
| 3037582 | Other | TN | CIGNA |
| 4317478 | Other | TN | BCBS - TENNCARE SELECT |
| 4317478 | Other | TN | BCBS - BLUE PREFERRED |
| 1527480 | Other | TN | TENNCARE, EFFECTIVE 4/5/12 |
| 1527480 | Medicaid | TN | |
| 4317478 | Other | TN | BCBS - BLUECARE |
| 454102553 | Other | TN | HUMANA GOLD |
| 616644300 | Other | TN | DEPT OF LABOR WOKER'S COMP - FECA PROGRAM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 9332 (Tennessee) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Anthony Wallace, CRNA 969 Oak Ridge Tpke # 316, Oak Ridge, TN 37830-8832 Ph: (865) 256-7711 | Richard Anthony Wallace, CRNA 8045 Roane Medical Center Dr, Harriman, TN 37748-8333 Ph: (865) 316-1000 |
Patricia L Douglas, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 412 Devonia St, Harriman, TN 37748 Phone: 865-882-1323 | |
Conway Ella, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 412 Devonia St, Harriman, TN 37748 Phone: 423-882-1323 |