William Jacob Wallace, PA
William Jacob Wallace, PA is a Physician Assistant in Cookeville, Tennessee. Qualified in 2014, 12 years ago. Practices with Campbell Clinic, PC, a 225-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Tennessee.
- Years since qualifying
- 12
- Licensed in
- TN
- In the registry since
- 2015
- Specialties on file
- 2
What do these letters mean?
- PA — Physician Assistant
- A licensed clinician who examines, diagnoses and treats under a physician's supervision.
Practice location Address checks out
105 S Willow AveCookeville, TN 38501-4667
Phone: (931) 372-7716
Fax: (931) 372-0087
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (2)
- 203 N Cedar Ave, Cookeville, TN 38501 — (931) 528-1992
- 150 Sam Walton Dr, Sparta, TN 38583-8815 — (931) 739-4000
Specialties & licences
| Surgical Physician Assistant (primary) | Taxonomy 363AS0400X · Licence PA2743 (TN) |
|---|---|
| Medical Physician Assistant | Taxonomy 363AM0700X · Licence 2743 (TN) |
Record details
| NPI number | 1992183412 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA |
| Sole proprietor | Yes |
| NPI enumerated | May 16, 2015 |
| Last updated in NPPES | August 27, 2020 |
| Certification date | August 27, 2020 |
| Mailing address | 203 N Cedar Ave, Cookeville, TN 38501-2498 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2014 (12 years in practice) |
| Group practice | Campbell Clinic, Pc — 225 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 4 on file with Medicare |
Other providers in Cookeville
-
Lucas Tyler Pittman, PHYSICIANASSISTANT
340 N Cedar Ave, Cookeville, TN 38501-2421 · (931) 783-5353
-
James M Vance, PA
350 S Lowe Ave Ste A, Cookeville, TN 38501 · (931) 526-1050
-
Vivian Family Medical LLC
675 S Jefferson Ave, Cookeville, TN 38501-0949 · (931) 520-0148
-
Mr. Timothy E Vivian, PA
675 S Jefferson Ave, Cookeville, TN 38501-0949 · (931) 520-0148