Mr Terrell Richard Wallace Jr, PA C in Warner Robins, GA

Mr Terrell Richard Wallace Jr, PA C is a Physician Assistant - Medical based in Warner Robins, Georgia. Mr Terrell Richard Wallace Jr is licensed to practice in Georgia (license number 002665) and his current practice location is 136 South Houston Lake Road, Warner Robins, Georgia. He can be reached at his office (for appointments etc.) via phone at (478) 953-1020.

NPI number for Mr Terrell Richard Wallace Jr is 1356399828 and his current mailing address is 207 Esplanade Drive, Warner Robins, Georgia. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1356399828.

Contact Information

	Mr Terrell Richard Wallace Jr, PA C
	136 South Houston Lake Road, Warner Robins, GA 31088
	(478) 953-1020
	(478) 953-5406

Map and Direction

Provider's Profile

Full Name	Mr Terrell Richard Wallace Jr
Gender	Male
Speciality	Physician Assistant - Medical
Location	136 South Houston Lake Road, Warner Robins, Georgia
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1356399828
Provider Enumeration Date: 05/05/2006
Last Update Date: 09/18/2012

Medical Identifiers

Medical identifiers for Mr Terrell Richard Wallace Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1356399828	NPI	-	NPPES
DC3326	Other		MCR RR
P00162033	Other		MCR RR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AM0700X	Physician Assistant - Medical	002665 (Georgia)	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 Terrell Richard Wallace Jr is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Terrell Richard Wallace Jr, PA C 207 Esplanade Drive, Warner Robins, GA 31088 Ph: (478) 922-3061	Mr Terrell Richard Wallace Jr, PA C 136 South Houston Lake Road, Warner Robins, GA 31088 Ph: (478) 953-1020

Reviews and Comments

Physician Assistant Nurses in Warner Robins, GA

Le'tombria Seay, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 125 Russell Pkwy, Warner Robins, GA 31088 Phone: 478-923-9730
Amie Renee Daniels, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2054 Watson Blvd, Warner Robins, GA 31093 Phone: 478-918-0770 Fax: 478-918-0771
Andrew L. Ray, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3051 Watson Blvd, Suite 525, Warner Robins, GA 31093 Phone: 478-953-4563 Fax: 478-953-4683
Ngoc Tram Dang, Physician Assistant Medicare: Medicare Enrolled Practice Location: 1601 Watson Blvd, Warner Robins, GA 31093 Phone: 478-922-4281
Michelle Bos, Physician Assistant Medicare: Medicare Enrolled Practice Location: 125 Russell Parkway, Warner Robins, GA 31088 Phone: 478-923-9730 Fax: 478-923-5515
Mrs. Amanda Knauer Hale, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 114 Sutherlin Dr Ste 1c, Warner Robins, GA 31088 Phone: 478-287-6144
Chad Alan Desbiens, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 204 Bowen Dr, Warner Robins, GA 31088 Phone: 478-957-5465

Mr Terrell Richard Wallace Jr, PA C - Physician Assistant in Warner Robins, GA