Wallace Jackson Champlain, DO - Medicare Obstetrics & Gynecology in Tahlequah, OK

Wallace Jackson Champlain, DO is a medicare enrolled "Obstetrics & Gynecology" physician in Tahlequah, Oklahoma. His current practice location is 1500 E Downing St Ste 208, Tahlequah, Oklahoma. You can reach out to his office (for appointments etc.) via phone at (918) 456-2496.

Wallace Jackson Champlain is licensed to practice in Oklahoma (license number 1994) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1689648636.

Contact Information

Wallace Jackson Champlain, DO
1500 E Downing St Ste 208,
Tahlequah, OK 74464-3234
(918) 456-2496
(918) 456-7108



Physician's Profile

Full NameWallace Jackson Champlain
GenderMale
SpecialityObstetrics & Gynecology
Location1500 E Downing St Ste 208, Tahlequah, Oklahoma
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1689648636
  • Provider Enumeration Date: 02/15/2006
  • Last Update Date: 06/04/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 8527059328
  • Enrollment ID: I20040520000836

Medical Identifiers

Medical identifiers for Wallace Jackson Champlain such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689648636NPI-NPPES
100118860AMedicaidOK

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207V00000XObstetrics & Gynecology 1994 (Oklahoma)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Wallace Jackson Champlain allows following entities to bill medicare on his behalf.
Entity NameNortheastern Oklahoma Community Health Centers, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518070481
PECOS PAC ID: 3678482635
Enrollment ID: O20031104000417

News Archive

First Edition: September 22, 2010

Today's headlines focus on news surrounding tomorrow's six-month anniversary of the new health law and some of the specific provisions that will kick in on that day.

joimax to present C-Camsource HD Twister for endoscopic spinal surgery at 5th German Spine Congress

The 5th German Spine Congress (5. Jahrestagung der Deutschen Wirbelsaulengesellschaft (DWG)) will take place from 16 to 18 December 2010 at the Congress Centre in Bremen. joimax(R) is proud to present the innovative HD 5-in-1 complete system at their booth no.20: The C-Camsource(R)HD Twister offers state-of-the-art HD technology and works with both the joimax(R) HD endoscopes and HD flat screens producing an extremely precise and sharp picture and video imaging for endoscopic spinal surgery.

Cancer Research UK funds projects for new cancer study

A NEW funding scheme launched by Cancer Research UK today (Thursday) looks to bring new insight to some of cancer's biggest challenges.

New study finds that thirdhand smoke  increases lung cancer risk in mice

Researchers at the Department of Energy's Lawrence Berkeley National Laboratory (Berkeley Lab) identified thirdhand smoke, the toxic residues that linger on indoor surfaces and in dust long after a cigarette has been extinguished, as a health hazard nearly 10 years ago.

Read more Medical News

› Verified 4 days ago

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Wallace Jackson Champlain is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Wallace Jackson Champlain, DO
1500 E Downing Suite 208,
Tahlequah, OK 74464-3363

Ph: (918) 456-2496
Wallace Jackson Champlain, DO
1500 E Downing St Ste 208,
Tahlequah, OK 74464-3234

Ph: (918) 456-2496

News Archive

First Edition: September 22, 2010

Today's headlines focus on news surrounding tomorrow's six-month anniversary of the new health law and some of the specific provisions that will kick in on that day.

joimax to present C-Camsource HD Twister for endoscopic spinal surgery at 5th German Spine Congress

The 5th German Spine Congress (5. Jahrestagung der Deutschen Wirbelsaulengesellschaft (DWG)) will take place from 16 to 18 December 2010 at the Congress Centre in Bremen. joimax(R) is proud to present the innovative HD 5-in-1 complete system at their booth no.20: The C-Camsource(R)HD Twister offers state-of-the-art HD technology and works with both the joimax(R) HD endoscopes and HD flat screens producing an extremely precise and sharp picture and video imaging for endoscopic spinal surgery.

Cancer Research UK funds projects for new cancer study

A NEW funding scheme launched by Cancer Research UK today (Thursday) looks to bring new insight to some of cancer's biggest challenges.

New study finds that thirdhand smoke  increases lung cancer risk in mice

Researchers at the Department of Energy's Lawrence Berkeley National Laboratory (Berkeley Lab) identified thirdhand smoke, the toxic residues that linger on indoor surfaces and in dust long after a cigarette has been extinguished, as a health hazard nearly 10 years ago.

Read more News

› Verified 4 days ago


Obstetrics & Gynecology Doctors in Tahlequah, OK

Lana Dawn Myers, D.O.
Obstetrics & Gynecology
Medicare: Medicare Enrolled
Practice Location: 1201 East Ross Bypass, Tahlequah, OK 74464
Phone: 918-207-0991    Fax: 918-456-7570
Dr. David Richard Gahn, MD
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 100 S Bliss Ave, Hastings Indian Medical Center, Tahlequah, OK 74464
Phone: 918-458-3360    Fax: 918-458-3315
Dr. Greggory Jon Woitte, MD
Obstetrics & Gynecology
Medicare: Medicare Enrolled
Practice Location: 100 S Bliss Ave, Tahlequah, OK 74464
Phone: 918-458-3130    Fax: 918-458-3315
Tschantre Eujeania Dorsett, MD
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 1500 E Downing St Ste 208, Tahlequah, OK 74464
Phone: 918-456-2496    Fax: 918-456-7108
Dr. Calvin P. Monroe, M.D.
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 1500 E Downing St Ste 208, Tahlequah, OK 74464
Phone: 918-456-2496    Fax: 918-456-7108
Dr. William Trousdale,
Obstetrics & Gynecology
Medicare: Not Enrolled in Medicare
Practice Location: 100 S Bliss Ave, Tahlequah, OK 74464
Phone: 918-458-3100    

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