Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Jamie Marie Wallace, PA

Individual provider Surgical Physician Assistant · NPI 1255523346

Mrs. Jamie Marie Wallace, PA is a Physician Assistant in Alexandria, Louisiana. Qualified in 2007, 19 years ago. Practices with Cenla Urology Clinic LLC, a 6-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
19
Licensed in
LA
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3311 Prescott Rd Ste 201
Alexandria, LA 71301-3900
Phone: (318) 442-6767
Fax: (318) 441-1259
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence TEMP PERMIT (LA)

Record details

NPI number1255523346
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 13, 2007
Last updated in NPPESAugust 13, 2007

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Cenla Urology Clinic Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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