Dr Tyson Wallace, PHARM D | |
134 Bevill Ave, Gosnell, AR 72315 | |
(870) 751-9242 | |
(870) 751-9291 |
Full Name | Dr Tyson Wallace |
---|---|
Gender | Male |
Speciality | Pharmacist |
Location | 134 Bevill Ave, Gosnell, Arkansas |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982296877 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
183500000X | Pharmacist | 2007005629 (Missouri) | Secondary |
183500000X | Pharmacist | PD09924 (Arkansas) | Primary |
Mailing Address | Practice Location Address |
---|---|
Dr Tyson Wallace, PHARM D 134 Bevill Ave, Gosnell, AR 72315 Ph: (870) 751-9242 | Dr Tyson Wallace, PHARM D 134 Bevill Ave, Gosnell, AR 72315 Ph: (870) 751-9242 |
Natalie Crockett, Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 134 Bevill St, Gosnell, AR 72315 Phone: 870-751-9242 | |
Dr. Brandon Glenn Michael, PHARM.D Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 134 Bevill Avenue, Gosnell, AR 72315 Phone: 870-751-9242 Fax: 870-751-9291 |