Jeffrey W Wallace, PA-C
Jeffrey W Wallace, PA-C is a Physician Assistant in Wentzville, Missouri. Qualified in 2004, 22 years ago. Practices with SSM Medical Group Inc, a 560-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.
- Years since qualifying
- 22
- Licensed in
- MO
- In the registry since
- 2007
- Specialties on file
- 3
What do these letters mean?
- PA-C — Physician Assistant, Certified
- A physician assistant who holds current national certification.
Practice location Address checks out
1601 Wentzville Pkwy Ste 117Wentzville, MO 63385-3814
Phone: (636) 332-8477
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 112 Piper Hill Dr, Saint Peters, MO 63376-1690 — (636) 441-3444
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 2005024101 (MO) |
|---|---|
| Medical Physician Assistant | Taxonomy 363AM0700X · Licence 2005024101 (MO) |
| Surgical Physician Assistant | Taxonomy 363AS0400X · Licence 2005024101 (MO) |
Record details
| NPI number | 1649479171 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA-C |
| Sole proprietor | No |
| NPI enumerated | July 14, 2007 |
| Last updated in NPPES | July 24, 2025 |
| Certification date | July 24, 2025 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2004 (22 years in practice) |
| Group practice | Ssm Medical Group Inc — 560 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 4 on file with Medicare |