Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
WILLIAM JACOB WALLACE, PA
Active Sole ProprietorWILLIAM JACOB WALLACE, PA is a Surgical Physician Assistant healthcare provider located in COOKEVILLE, Tennessee. NPI 1992183412 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · COOKEVILLE, TN
Registration Details
- NPI Number
- 1992183412
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 16, 2015 (11.270802603907 yrs)
- Last Updated
- Aug 27, 2020
- Licenses
-
2743 (TN)PA2743 (TN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
105 S WILLOW AVECOOKEVILLE, TN, 385014667Browse TN providers · Browse ZIP 38501
- Phone
- 9313727716
- Fax
- 9313720087
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
- Additional Specialty
- Surgical Physician Assistant
Other Surgical Physician Assistant Providers in COOKEVILLE, TN
| Name | Credential | NPI |
|---|---|---|
| MR. CHRISTOPHER L. NELSON | PA | 1114911971 |
| JULIANNE F BUCKNER | PA-C | 1912986829 |
| MR. STEVEN BICKEL | PA-C | 1265480867 |
| MR. JERRY A. CRUMP | C.R.N.F.A. | 1942301072 |
| JUSTIN LINK COX | P.A. | 1285006635 |
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.