Individual provider · Type 1 NPI

Trevor J. Wallace, PA-C

Physician Assistant · Oak Ridge, TN

NPI number 1396281200 Active

Practice location

988 Oak Ridge Tpke Ste 100
Oak Ridge, TN 37830-6919

Call (865) 690-4861 Map

Fax (865) 483-4194

Mailing address

PO Box 160909
Altamonte Springs, FL 32716-0909

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X6270 (TN)
Physician Assistant 363A00000X8236 (GA)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1396281200

Trevor J. Wallace, PA-C's National Provider Identifier is 1396281200, issued on Jan 17, 2017. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Oak Ridge, TN. The record was last updated on Oct 28, 2026.