Mrs Jordan Jehree Wallace, PA-C in Little Rock, AR

Mrs Jordan Jehree Wallace, PA-C is a medicare enrolled "Physician Assistant - Medical" in Little Rock, Arkansas. Her current practice location is 4301 W Markham St # 721, Little Rock, Arkansas. You can reach out to her office (for appointments etc.) via phone at (501) 526-6062.

Mrs Jordan Jehree Wallace is licensed to practice in Arkansas (license number PA-1208) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063291789.

Contact Information

	Mrs Jordan Jehree Wallace, PA-C
	4301 W Markham St # 721, Little Rock, AR 72205-7101
	(501) 526-6062
	(501) 686-5780

Map and Direction

Provider's Profile

Full Name	Mrs Jordan Jehree Wallace
Gender	Female
Speciality	Physician Assistant - Medical
Location	4301 W Markham St # 721, Little Rock, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063291789
Provider Enumeration Date: 09/22/2023
Last Update Date: 11/02/2023

Medicare PECOS Information:

PECOS PAC ID: 5890143077
Enrollment ID: I20231129000015

Medical Identifiers

Medical identifiers for Mrs Jordan Jehree Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063291789	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AM0700X	Physician Assistant - Medical	PA-1208 (Arkansas)	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. Mrs Jordan Jehree 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
Mrs Jordan Jehree Wallace, PA-C 4301 W Markham St # 783, Little Rock, AR 72205-7101 Ph: (501) 686-8000	Mrs Jordan Jehree Wallace, PA-C 4301 W Markham St # 721, Little Rock, AR 72205-7101 Ph: (501) 526-6062

Reviews and Comments

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Mrs Jordan Jehree Wallace, PA-C - Medicare Physician Assistant in Little Rock, AR