Individual provider · Type 1 NPI

Jamie Marie Wallace, P.A.

Surgical Physician Assistant · Alexandria, LA

NPI number 1255523346 Active

Practice location

3311 Prescott Rd, Suite 201
Alexandria, LA 71301-3900

Fax (318) 441-1259

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XTEMP PERMIT (LA)

Surgical Physician Assistant: Definition to come...

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About NPI 1255523346

Jamie Marie Wallace, P.A.'s National Provider Identifier is 1255523346, issued on Aug 13, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Alexandria, LA. The record was last updated on Aug 13, 2007.