Wallace, Jason R

Wallace, Jason R is an individual health care provider with primary practice located at 95 S Pagosa Blvd , Pagosa Springs CO 81147-8329. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wallace, Jason R can be contacted via phone (970) 731-3700.

Contact Information

Primary practice address
95 S Pagosa Blvd Pagosa Springs CO 81147-8329
Phone: (970) 731-3700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X DR.0050788 Colorado

Profile Details

NPI number 1992020937
LBN Legal business name Wallace, Jason R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2010
Last updated Jul 22nd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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