Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JASON R WALLACE, DO
ActiveJASON R WALLACE, DO is a Family Medicine healthcare provider located in PAGOSA SPRINGS, Colorado. NPI 1992020937 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · PAGOSA SPRINGS, CO
Registration Details
- NPI Number
- 1992020937
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 1, 2010 (16.186220270501 yrs)
- Last Updated
- Jul 22, 2020
- License
-
DR.0050788 (CO)
Practice Information
- Address
-
95 S PAGOSA BLVDPAGOSA SPRINGS, CO, 811478329Browse CO providers · Browse ZIP 81147
- Phone
- 9707313700
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in PAGOSA SPRINGS, CO
| Name | Credential | NPI |
|---|---|---|
| DR. JOHN D WISNESKI | M.D. | 1982699039 |
| DR. ROBERT FARRINGTON BROWN | M.D. | 1316997638 |
| MRS. CAROLE NASRALLA | MD | 1386672491 |
| JAMES C PRUITT | M.D. | 1588697361 |
| DR. BARTON ELGIN GIESSEL | M.D. | 1578616504 |
| DR. JOANNA ERIKA ESTES | M.D. | 1942422480 |
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.