Individual provider · Type 1 NPI

Donetta Wallace, P.A.-C

Physician Assistant · Paintsville, KY

NPI number 1417958828 Active

Practice location

336 N Mayo Trl
Paintsville, KY 41240-1804

Fax (606) 788-0253

Mailing address

PO Box 2379
Ashland, KY 41105-2379

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700XPA544 (KY)
Physician Assistant Primary 363A00000XPA544 (KY)

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 1417958828

Donetta Wallace, P.A.-C's National Provider Identifier is 1417958828, issued on Aug 9, 2005. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Paintsville, KY. The record was last updated on Feb 1, 2022.