Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Erik Jack Wallace, PA-C

Individual provider Physician Assistant · NPI 1063193084

Erik Jack Wallace, PA-C is a Physician Assistant in Bethlehem, Pennsylvania. Qualified in 2023, 3 years ago. Practices with Gslpg, Inc, a 267-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
3
Licensed in
PA
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

801 Ostrum St
Bethlehem, PA 18015-1000
Phone: (866) 785-8537
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 20 Highland View Ct, Easton, PA 18042-9792 — (484) 619-5066

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA065385 (PA)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1063193084
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJuly 31, 2023
Last updated in NPPESFebruary 12, 2024
Certification dateFebruary 12, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Gslpg, Inc — 267 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Bethlehem