Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
WALLACE JACKSON CHAMPLAIN, DO
ActiveWALLACE JACKSON CHAMPLAIN, DO is a Obstetrics & Gynecology healthcare provider located in TAHLEQUAH, Oklahoma. NPI 1689648636 is currently active in the NPPES registry. Verify at CMS.
Obstetrics & Gynecology · TAHLEQUAH, OK
Registration Details
- NPI Number
- 1689648636
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 15, 2006 (20.483794922036 yrs)
- Last Updated
- Jun 4, 2019
- License
-
1994 (OK)
Practice Information
- Address
-
1500 E DOWNING ST STE 208TAHLEQUAH, OK, 744643234Browse OK providers · Browse ZIP 74464
- Phone
- 9184562496
- Fax
- 9184567108
- Primary Specialty
-
Obstetrics & Gynecology
207V00000X
Other Obstetrics & Gynecology Providers in TAHLEQUAH, OK
| Name | Credential | NPI |
|---|---|---|
| DR. DAVID RICHARD GAHN | MD | 1275523839 |
| DR. GREGGORY JON WOITTE | MD | 1336130202 |
| MR. JOHN RICHARD DOSS | M.D. | 1881654978 |
| TSCHANTRE EUJEANIA DORSETT | MD | 1417117565 |
| MIRANDA DAWN KNIGHT-BROWN | M.D. | 1063770212 |
| DR. KAYLA JEANNE CAGLE-COLON | M.D. | 1134582034 |
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.