| Dr Gregory Wallis, DO | |
|
835 Se Bishop Blvd, Pullman, WA 99163-5512 | |
| (509) 332-2541 | |
| Not Available |
| Full Name | Dr Gregory Wallis |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 5 Years |
| Location | 835 Se Bishop Blvd, Pullman, Washington |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790308278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | OP61426716 (Washington) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Pullman Regional Hospital | Pullman, WA | Hospital |
| Parker Indian Health Center | Parker, AZ | Hospital |
| Hopi Health Care Center | Polacca, AZ | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Dhhs Ihs Phoenix Area | 0244405629 | 38 |
| Entity Name | Dhhs Ihs Phoenix Area |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396022026 PECOS PAC ID: 0244405629 Enrollment ID: O20120105000013 |
| Entity Name | Dhhs Ihs Phoenix Area |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265719934 PECOS PAC ID: 7810163011 Enrollment ID: O20120109000961 |
| Entity Name | Dhhs Ihs Phoenix Area |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356628028 PECOS PAC ID: 9436325420 Enrollment ID: O20120222000148 |
| Entity Name | Irene Benn Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841535317 PECOS PAC ID: 0840430724 Enrollment ID: O20130717000832 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gregory Wallis, DO Po Box 95461, Cleveland, OH 44101-0033 Ph: (928) 669-2137 | Dr Gregory Wallis, DO 835 Se Bishop Blvd, Pullman, WA 99163-5512 Ph: (509) 332-2541 |
Dr. Gerardo R Rodriquez, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 835 Se Bishop Blvd, Pullman, WA 99163 Phone: 509-336-7388 Fax: 509-336-7389 | |
Dr. Larry E Brown, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 835 Se Bishop Blvd, Pullman, WA 99163 Phone: 509-336-7388 Fax: 509-336-7389 | |
Dr. Stephen C Bergmann, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 835 Se Bishop Blvd, Pullman, WA 99163 Phone: 509-336-7388 Fax: 509-336-7389 | |
Dr. Clifford Louis Lightfoot Iii, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 835 Se Bishop Blvd, Pullman, WA 99163 Phone: 509-336-7386 | |
Dr. Peter M Mikkelsen, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 835 Se Bishop Blvd, Pullman, WA 99163 Phone: 509-336-7388 Fax: 509-336-7389 |