Individual provider · Type 1 NPI
Benjamin Pantone Wallace, PA
Surgical Physician Assistant · Salt Lake City, UT
NPI number
1992936066
Active
Practice location
1160 E 3900 S Ste 3500
Salt Lake City, UT 84124-1264
Mailing address
PO Box 281490
Atlanta, GA 30384-1490
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | None listed |
Surgical Physician Assistant: Definition to come...
4 other providers at this address
- Briana Civello, ACNPNurse Practitioner Salt Lake City, UT NPI 1669236444
- Gabriel Dan Frampton, PA-CSurgical Physician Assistant Salt Lake City, UT NPI 1063882272
- Kelsey Slugocki, PA-CPhysician Assistant Salt Lake City, UT NPI 1265988299
- Rafe C. Connors, MDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician Salt Lake City, UT NPI 1497954416
Other surgical physician assistant providers in Salt Lake City
- Staci Lee Gunter, PA-CSurgical Physician Assistant Salt Lake City, UT NPI 1003329962
- Scott C. Frischknecht, PA-CSurgical Physician Assistant Salt Lake City, UT NPI 1013901792
- Chris AndersonSurgical Physician Assistant Salt Lake City, UT NPI 1043699101
- John Evan Thomas, PA-CSurgical Physician Assistant Salt Lake City, UT NPI 1053838532
- Gabriel Dan Frampton, PA-CSurgical Physician Assistant Salt Lake City, UT NPI 1063882272
- Iliana Thornton, PA-CSurgical Physician Assistant Salt Lake City, UT NPI 1073971644
- Heather M. George, PA-CSurgical Physician Assistant Salt Lake City, UT NPI 1093068017
- Michael A. Pond, PACSurgical Physician Assistant Salt Lake City, UT NPI 1104005503
About NPI 1992936066
Benjamin Pantone Wallace, PA's National Provider Identifier is 1992936066, issued on Aug 6, 2009. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Salt Lake City, UT. The record was last updated on Jan 2, 2026.