Dr Dustin P Wallace, PHD - Psychologist in Kansas City, MO

Dr Dustin P Wallace, PHD is a Psychologist - Clinical Child & Adolescent based in Kansas City, Missouri. Dr Dustin P Wallace is licensed to practice in Missouri (license number 2010009609) and his current practice location is 2401 Gillham Rd, Kansas City, Missouri. He can be reached at his office (for appointments etc.) via phone at (816) 234-3000.

NPI number for Dr Dustin P Wallace is 1710143250 and his current mailing address is 2401 Gillham Rd, Kansas City, Missouri. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1710143250.

Contact Information

Dr Dustin P Wallace, PHD
2401 Gillham Rd,
Kansas City, MO 64108-4619
(816) 234-3000
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDr Dustin P Wallace
GenderMale
SpecialityPsychologist - Clinical Child & Adolescent
Location2401 Gillham Rd, Kansas City, Missouri
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1710143250
  • Provider Enumeration Date: 08/04/2008
  • Last Update Date: 02/03/2015

Medical Identifiers

Medical identifiers for Dr Dustin P Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710143250NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC2200XPsychologist - Clinical Child & Adolescent 2010009609 (Missouri)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. Dr Dustin P Wallace 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 AddressPractice Location Address
Dr Dustin P Wallace, PHD
2401 Gillham Rd,
Kansas City, MO 64108-4619

Ph: (816) 234-3000
Dr Dustin P Wallace, PHD
2401 Gillham Rd,
Kansas City, MO 64108-4619

Ph: (816) 234-3000

Reviews and Comments


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