Stephen Wallace, MD | |
1200 College Dr, Rock Springs, WY 82901-5868 | |
(307) 362-3711 | |
(307) 352-8178 |
Full Name | Stephen Wallace |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 1200 College Dr, Rock Springs, Wyoming |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851379119 | NPI | - | NPPES |
605960009 | Other | WY | FBL |
314686 | Other | WY | BSWY |
806470900 | Medicaid | ID | |
58024 | Other | ID | BLUE CROSS OF ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | M8716 (Idaho) | Secondary |
207P00000X | Emergency Medicine | 6690A (Wyoming) | Primary |
Entity Name | University Of Utah Adult Services |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104204361 PECOS PAC ID: 0941525273 Enrollment ID: O20150625001685 |
Entity Name | Sublette County Hospital District |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104410596 PECOS PAC ID: 5496163461 Enrollment ID: O20210518002474 |
Mailing Address | Practice Location Address |
---|---|
Stephen Wallace, MD 505 S 336th St, Suite 600, Federal Way, WA 98003-6328 Ph: (253) 838-6180 | Stephen Wallace, MD 1200 College Dr, Rock Springs, WY 82901-5868 Ph: (307) 362-3711 |
Jonathan R Roddy, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1200 College Dr, Rock Springs, WY 82901 Phone: 307-352-8350 Fax: 307-352-8178 | |
Ronald James Mckee, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1200 College Dr, Rock Springs, WY 82901 Phone: 307-352-8350 Fax: 307-352-8178 | |
Dr. Howard Wm Burns, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1200 College Dr, Rock Springs, WY 82901 Phone: 307-875-7730 | |
Dr. Kathryn Ann Collins, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1200 College Dr, Rock Springs, WY 82901 Phone: 307-875-7730 | |
John A Sherman, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1200 College Drive, Rock Springs, WY 82901 Phone: 307-352-8350 Fax: 307-352-8178 | |
Dr. Fergus Thornton, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1200 College Dr, Rock Springs, WY 82901 Phone: 307-352-8350 Fax: 307-352-8178 |