National Provider Identifier Database

JARED L WALLACE, PA-C – NPI #1063746667
Physician Assistant

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.


Contact Information

JARED L WALLACE, PA-C
43783 KENAI SPUR HWY
KENAI, AK99611
Phone: 907-283-9116
Fax: 907-283-9122
Website:
Specialty Taxonomy Code
* Physician Assistant 363A00000X

* Indicates primary specialty

NPI Profile & details for JARED L WALLACE

NPI Number 1063746667
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 09/29/2009
Last updated 03/07/2023 - About 3 years ago
Sole proprietor1 No
Identifiers
  • AK Medicaid: 1020379
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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