DARCIE L WALLACE PA-C NPI 1083648489

NPI Information

NPI: 1083648489
Provider Name: DARCIE L WALLACE, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
615 S NEW BALLAS RD
SAINT LOUIS, MO
ZIP 63141
Phone: (314) 251-6000
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Darcie L Wallace, PA-C is a surgical physician assistant in Saint Louis, MO. Darcie L Wallace, PA-C NPI is 1083648489. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

615 S NEW BALLAS RD
SAINT LOUIS, MO
ZIP 63141-221
Phone: (314) 251-6000

The enumeration date for this NPI number is 7/10/2006 and was last updated on 10/22/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	118539	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1016860	OTHER	MISSOURI	NCCPA CERT #
2	004085007	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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