Russell R Gist Od PC

NPI #1700831492 in Ankeny, Iowa

Provider Information

NPI Number: 1700831492
Entity Type: Organization
Organization Name: Russell R Gist Od PC
Primary Specialty: Optometrist
Enumeration Date: May 23, 2006
Last Updated: Nov 15, 2007

Practice Location

Address: 1810 SW WHITE BIRCH CIR
Address 2: SUITE 109
City: Ankeny
State: Iowa
ZIP Code: 50023-7226
Phone: (515) 965-8488

Authorized Official

Name: RUSSELL R GIST, O.D.
Title: PRESIDENT
Phone: (515) 965-8488

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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