| Mr Terrell Richard Wallace Jr, PA C | |
|
136 South Houston Lake Road, Warner Robins, GA 31088 | |
| (478) 953-1020 | |
| (478) 953-5406 |
| Full Name | Mr Terrell Richard Wallace Jr |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Medical |
| Location | 136 South Houston Lake Road, Warner Robins, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356399828 | NPI | - | NPPES |
| DC3326 | Other | MCR RR | |
| P00162033 | Other | MCR RR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 002665 (Georgia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Terrell Richard Wallace Jr, PA C 207 Esplanade Drive, Warner Robins, GA 31088 Ph: (478) 922-3061 | Mr Terrell Richard Wallace Jr, PA C 136 South Houston Lake Road, Warner Robins, GA 31088 Ph: (478) 953-1020 |
Le'tombria Seay, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 125 Russell Pkwy, Warner Robins, GA 31088 Phone: 478-923-9730 | |
Amie Renee Daniels, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2054 Watson Blvd, Warner Robins, GA 31093 Phone: 478-918-0770 Fax: 478-918-0771 | |
Andrew L. Ray, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3051 Watson Blvd, Suite 525, Warner Robins, GA 31093 Phone: 478-953-4563 Fax: 478-953-4683 | |
Ngoc Tram Dang, Physician Assistant Medicare: Medicare Enrolled Practice Location: 1601 Watson Blvd, Warner Robins, GA 31093 Phone: 478-922-4281 | |
Mrs. Amanda Knauer Hale, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 114 Sutherlin Dr Ste 1c, Warner Robins, GA 31088 Phone: 478-287-6144 | |
Chad Alan Desbiens, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 204 Bowen Dr, Warner Robins, GA 31088 Phone: 478-957-5465 | |
Timothy Ray Luschen, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 623 S Houston Lake Rd, Suite 200, Warner Robins, GA 31088 Phone: 478-923-6633 Fax: 478-923-8444 |