Dr JEFFREY W WALLACE PA is a male medical professional, specializing in Physician Assistant. He graduated in 2004.
SSM MEDICAL GROUP INC
3555 SUNSET OFFICE DR
SUITE C100
SAINT LOUIS
MO
631271014
Tel: 3142389100
| Npi | 1649479171 |
| Pac Id | 0042269557 |
| Professional Enrollment Id | I20130729001001 |
| Last Name | WALLACE |
| First Name | JEFFREY |
| Middle Name | W |
| Suffix | |
| Gender | M |
| Credential | PA |
| Medical School Name | OTHER |
| Graduation Year | 2004 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
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| Organization Legal Name | SSM MEDICAL GROUP INC |
| Group Practice Pac Id | 6608776299 |
| Number Of Group Practice Members | 499 |
| Line 1 Street Address | 3555 SUNSET OFFICE DR |
| Line 2 Street Address | SUITE C100 |
| Marker Of Address Line 2 Suppression | |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 631271014 |
| Phone Number | 3142389100 |
| Hospital Affiliation Ccn 1 | 260005 |
| Hospital Affiliation Lbn 1 | SSM ST JOSEPH HEALTH CENTER |
| Hospital Affiliation Ccn 2 | 260200 |
| Hospital Affiliation Lbn 2 | SSM ST JOSEPH HOSPITAL WEST |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
| Hospital Affiliation Ccn 4 | |
| Hospital Affiliation Lbn 4 | |
| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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