Mr John David Wallace, PA-C is a medicare enrolled "Physician Assistant" in East Jordan, Michigan. His current practice location is
601 Bridge St, East Jordan, Michigan. You can reach out to his office (for appointments etc.) via phone at
(231) 536-2206.
Mr John David Wallace is licensed to practice in Michigan (license number 5601006422) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1487909511.
Provider's Profile
Full Name | Mr John David Wallace |
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Gender | Male |
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Speciality | |
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Experience | Years |
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Location | 601 Bridge St, East Jordan, Michigan |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mr John David Wallace attended and graduated from in
NPI Data:
- NPI Number: 1487909511
- Provider Enumeration Date: 07/15/2012
- Last Update Date: 09/20/2022
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Mr John David Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1487909511 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 5601006422 (Michigan) | 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. Mr John David 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 |
Mr John David Wallace, PA-C 601 Bridge St, East Jordan, MI 49727-9383 Ph: (231) 536-2206 | Mr John David Wallace, PA-C 601 Bridge St, East Jordan, MI 49727-9383 Ph: (231) 536-2206 |
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