Individual
RUSSELL R GIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1810 SW WHITE BIRCH CIR STE 109, ANKENY, IA 50023-7226
(515) 965-8488
(515) 965-8499
Mailing address
SUITE #109, 1810 SW WHITE BIRCH CIRCLE, ANKENY, IA 50023-7226
(515) 965-8488
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
IA02183
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09236
WELLMARK
IA
01
—
11588747
UNITED HEALTH CARE
IA
01
—
204258792
PRINCIPAL
IA
01
—
240864
MIDLAND CHOICE
IA
01
—
275697
COVENTRY
IA
01
—
38829
AVESIS
IA
01
—
41502
SPECTERA
IA
01
—
5159658488
VSP
IA
01
—
53055
DAVIS
IA
05
—
5420588
—
IA
Enumeration date
02/27/2006
Last updated
12/08/2022
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