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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 SurgeryInferred 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