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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. TERRELL RICHARD WALLACE JR., PA C

Active

MR. TERRELL RICHARD WALLACE JR., PA C is a Medical Physician Assistant healthcare provider located in WARNER ROBINS, Georgia. NPI 1356399828 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · WARNER ROBINS, GA

Registration Details

NPI Number
1356399828
Provider Type
Individual
Gender
Male
NPI Issued
May 5, 2006 (20.258230176996 yrs)
Last Updated
Sep 18, 2012
License
002665 (GA)

Practice Information

Address
136 SOUTH HOUSTON LAKE ROAD
WARNER ROBINS, GA, 31088
Browse GA providers · Browse ZIP 31088
Phone
4789531020
Fax
4789535406
Primary Specialty
Medical Physician Assistant
363AM0700X

Other Medical Physician Assistant Providers in WARNER ROBINS, GA

Name Credential NPI
MRS. LANA K LOTT PA-C 1629026117
MS. DEBORAH J BESSINGER P.A. 1952490302
PAUL D DESSART PA-C 1669592093
MRS. AMANDA KNAUER HALE PA-C 1235432519
JAMIE BATTLE GIVENS PA-C 1598027740
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.