Wallace Jackson Champlain, DO is an obstetrics gynecology in Tahlequah, OK. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Wallace Jackson Champlain, DO NPI is 1689648636. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
1500 E DOWNING ST STE 208
TAHLEQUAH, OK
ZIP 74464-234
Phone: (918) 456-2496
Fax: (918) 456-7108
The NPI 1689648636 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 2/15/2006 and was last updated on 6/4/2019.