| Mr Roy Erickson Wallace, PA | |
|
1 Jarrett White Rd, Tamc, Personnel Division, Tamc, HI 96859-5001 | |
| (808) 433-1790 | |
| Not Available |
| Full Name | Mr Roy Erickson Wallace |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 1 Jarrett White Rd, Tamc, Hawaii |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134191885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Roy Erickson Wallace, PA 784 Ringold St, Apt 11, Wahiawa, HI 96786-3857 Ph: (808) 351-7495 | Mr Roy Erickson Wallace, PA 1 Jarrett White Rd, Tamc, Personnel Division, Tamc, HI 96859-5001 Ph: (808) 433-1790 |
Mr. Richard Dario Ares, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1 Jarrett White Rd, Tamc, HI 96859 Phone: 808-433-8393 Fax: 808-433-8392 | |
Mrs. Dawn Keefe Duff, P.A.-C. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1 Jarrett White Rd, Tamc, HI 96859 Phone: 808-433-6661 | |
Mr. Kenneth Warren Smith Sr., APA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1 Jarrett White Rd, Tripler Army Medical Center Attn: Mchk-qs, Tamc, HI 96859 Phone: 808-433-2460 Fax: 808-433-1558 |