| Wallace Glenn Jamison, MD | |
|
3285 122nd Ave, Allegan, MI 49010-9511 | |
| (269) 673-6617 | |
| Not Available |
| Full Name | Wallace Glenn Jamison |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3285 122nd Ave, Allegan, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215943279 | NPI | - | NPPES |
| 168245EU | Other | PREFERRED CARE | |
| P010234609 | Other | BLUE CHOICE | |
| 168245EU | Other | NY | PREFERRED CARE |
| P010234609 | Other | NY | BLUE CHOICE |
| 02643823 | Medicaid | NY | |
| P020234609 | Other | ROCHESTER BLUE SHIELD | |
| RA6483 | Other | NY | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 234609 (New York) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 4301508760 (Michigan) | Primary |
| Entity Name | St Josephs Hospital Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508815333 PECOS PAC ID: 9234043324 Enrollment ID: O20031113000400 |
| Mailing Address | Practice Location Address |
|---|---|
| Wallace Glenn Jamison, MD 29 Northwest Blvd, Nashua, NH 03063-4068 Ph: (603) 577-5721 | Wallace Glenn Jamison, MD 3285 122nd Ave, Allegan, MI 49010-9511 Ph: (269) 673-6617 |
Dr. Cherri M Miner, Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 4245 117th Ave, Allegan, MI 49010 Phone: 317-748-7757 | |
Dr. Michael Fusillo, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 551 Linn St, Suite 230, Allegan, MI 49010 Phone: 269-686-4110 Fax: 269-686-2135 |