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

MR. MICHAEL DWAYNE WALL, PA, ATC, PTA, CEAS

Active

MR. MICHAEL DWAYNE WALL, PA, ATC, PTA, CEAS is a Physician Assistant healthcare provider located in POWELL, Tennessee. NPI 1386794717 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · POWELL, TN

Registration Details

NPI Number
1386794717
Provider Type
Individual
Gender
Male
NPI Issued
Jan 10, 2007 (19.40994810338 yrs)
Last Updated
Jun 14, 2010
Licenses
3396 (TN)
110102223 (TN)
PENDING (TN)

Practice Information

Address
7557 DANNAHER WAY
SUITE 230
POWELL, TN, 378493558
Browse TN providers · Browse ZIP 37849
Phone
8659385222
Fax
8659385264
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Athletic Trainer
Additional Specialty
Physician Assistant

Other Physician Assistant Providers in POWELL, TN

Name Credential NPI
FRANCES L DO PA 1629260542
SCOTT H. CARR PA-C 1689814899
MRS. STEPHANIE K LEZATTE PA-C 1902128812
MRS. LAUREN L. CLEAR PA 1851662498
ROBERT STEPHEN EDMONDS PA-C 1467834838
ASHLEY LYNN SHEHANE PA-C 1578073219
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.