Ms Marquita Diane Wallace, in Covington, LA

Ms Marquita Diane Wallace, is a medicare enrolled "Dentist" provider in Covington, Louisiana. Her current practice location is 600 N Highway 190, Suite 4, Covington, Louisiana. You can reach out to her office (for appointments etc.) via phone at (615) 887-1379.

Ms Marquita Diane Wallace is licensed to practice in Louisiana (license number 6135) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1598087900.

Contact Information

	Ms Marquita Diane Wallace,
	600 N Highway 190, Suite 4, Covington, LA 70433-5003
	(615) 887-1379
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Ms Marquita Diane Wallace
Gender	Female
Speciality	Dentist
Location	600 N Highway 190, Covington, Louisiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1598087900
Provider Enumeration Date: 02/26/2010
Last Update Date: 09/25/2013

Medicare PECOS Information:

PECOS PAC ID: 9133423312
Enrollment ID: I20160209000863

Medical Identifiers

Medical identifiers for Ms Marquita Diane Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1598087900	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	6135 (Louisiana)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Marquita Diane Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ms Marquita Diane Wallace, 600 N Highway 190, Suite 4, Covington, LA 70433-5003 Ph: (615) 887-1379	Ms Marquita Diane Wallace, 600 N Highway 190, Suite 4, Covington, LA 70433-5003 Ph: (615) 887-1379

Reviews and Comments

Dentist in Covington, LA

Dr. Brooke Virginia Vinturella, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 189 Greenbrier Blvd Ste A, Covington, LA 70433 Phone: 985-892-5942
Griffin Lavelle Deen Jr., DDS Dentist Medicare: Medicare Enrolled Practice Location: 122 E 21st Ave, Covington, LA 70433 Phone: 985-867-9122 Fax: 985-867-9169
Dr. William Herrick Wayman, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 840 N Columbia St, Covington, LA 70433 Phone: 198-587-1393
Dr. Paul Van Nguyen, DDS Dentist Medicare: Medicare Enrolled Practice Location: 600 N Highway 190 Ste 4, Covington, LA 70433 Phone: 985-893-5522
Dr. Jason Singh Chawla, DMD Dentist Medicare: Medicare Enrolled Practice Location: 600 N Highway 190 Ste 4, Covington, LA 70433 Phone: 985-893-5522
Dr. Andrew Joseph Voelkel, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 604 S Tyler St, Covington, LA 70433 Phone: 985-892-2273 Fax: 985-892-2579
Colby Terry, Dentist Medicare: Medicare Enrolled Practice Location: 600 N Highway 190 Ste 4, Covington, LA 70433 Phone: 985-893-5522

Ms Marquita Diane Wallace, - Medicare Dentist in Covington, LA