| Dr Tyson Wallace, PHARM D | |
|
134 Bevill Ave, Gosnell, AR 72315 | |
| (870) 751-9242 | |
| (870) 751-9291 |
| Full Name | Dr Tyson Wallace |
|---|---|
| Gender | Male |
| Speciality | Pharmacist |
| Location | 134 Bevill Ave, Gosnell, Arkansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982296877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 183500000X | Pharmacist | 2007005629 (Missouri) | Secondary |
| 183500000X | Pharmacist | PD09924 (Arkansas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tyson Wallace, PHARM D 134 Bevill Ave, Gosnell, AR 72315 Ph: (870) 751-9242 | Dr Tyson Wallace, PHARM D 134 Bevill Ave, Gosnell, AR 72315 Ph: (870) 751-9242 |
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› Verified 9 days ago
Dr. Brandon Glenn Michael, PHARM.D Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 134 Bevill Avenue, Gosnell, AR 72315 Phone: 870-751-9242 Fax: 870-751-9291 |