SearchTennesseeSurgical Physician Assistant

William Wallace, PA

NPI 1992183412 · on the registry since 2015 · sole proprietor

Practice

Address
105 S Willow Ave
Cookeville, TN 38501
Phone
(931) 372-7716
Fax
(931) 372-0087
Organisation at this address
Campbell Clinic Pc
Upper Cumberland Orthopedic Surgery, Pc
Cumberland Neurological And Spinal Surgery
Inferred from a shared address, not stated in the registry.
Clinicians at this address
24

Additional practice sites

  • 150 Sam Walton Dr, Sparta, TN
  • 203 N Cedar Ave, Cookeville, TN

Registry record

Primary taxonomy
Surgical Physician Assistant
363AS0400X
Also registered as
Medical Physician Assistant
Licence states on file
TN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-08-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Tennessee