JEFFREY WALLACE, PA-C

Physician Assistant

Active Individual
NPI: 1649479171

Practice Address

1601 WENTZVILLE PKWY STE 117
Wentzville, MO 63385

Phone: (636) 332-8477

Specialties

Specialty Code Primary License
Physician Assistant - Medical 363AM0700X No 2005024101 (MO)
Physician Assistant - Surgical 363AS0400X No 2005024101 (MO)
Physician Assistant 363A00000X Yes 2005024101 (MO)

Frequently Asked Questions

NPI 1649479171 is the National Provider Identifier for JEFFREY WALLACE, PA-C, a Physician Assistant provider located in Wentzville, MO. This NPI was enumerated on July 14, 2007.
JEFFREY WALLACE, PA-C practices at 1601 WENTZVILLE PKWY STE 117, Wentzville, MO 63385.

Quick Facts

NPI
1649479171
Type
Individual
Enumerated
Jul 14, 2007
Last Updated
Jul 24, 2025

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