| Jeffrey W Wallace, PA-C | |
|
1601 Wentzville Pkwy Ste 117, Wentzville, MO 63385-3814 | |
| (636) 332-8477 | |
| Not Available |
| Full Name | Jeffrey W Wallace |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 20 Years |
| Location | 1601 Wentzville Pkwy Ste 117, Wentzville, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649479171 | NPI | - | NPPES |
| 2005024101 | Other | MO | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | 2005024101 (Missouri) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 2005024101 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ssm St Joseph Health Center | Saint charles, MO | Hospital |
| Ssm St Joseph Hospital West | Lake saint louis, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ssm Medical Group Inc | 6608776299 | 496 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey W Wallace, PA-C 112 Piper Hill Dr, First Floor, Saint Peters, MO 63376-1690 Ph: (636) 441-3444 | Jeffrey W Wallace, PA-C 1601 Wentzville Pkwy Ste 117, Wentzville, MO 63385-3814 Ph: (636) 332-8477 |
Jacqueline Sova Castagno, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1060 Meyer Rd, Wentzville, MO 63385 Phone: 314-230-1500 Fax: 314-230-1122 | |
Samuel R Nathan, PA-S Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 801 Medical Dr Ste 400, Wentzville, MO 63385 Phone: 636-332-8455 | |
Ms. Dawn M Calabrese, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1601 Wentzville Pkwy, Wentzville, MO 63385 Phone: 636-332-8455 | |
Mrs. Coralia Ilinca Leyderman, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1601 Wentzville Pkwy Ste 117, Wentzville, MO 63385 Phone: 636-332-8455 | |
Matthew Sotheran, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1601 Wentzville Pkwy Ste 117, Wentzville, MO 63385 Phone: 636-332-8477 | |
Lauren Evan Mcgaughey, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1060 Meyer Rd, Wentzville, MO 63385 Phone: 314-230-1500 Fax: 314-230-1122 |