Wally Jean (NPI# 1346654167, PAC ID# 4688982721) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL PRACTICE.
| Nation Provider ID (NPI) | 1346654167 |
| PAC ID by PECOS | 4688982721 |
| Professional Enrollment ID | I20151009000241 |
| Full Name | Wally Jean |
| Organization Legal Name | U S HEALTH DEPT OF HEALTH AND HUMAN SERVICES |
| Address |
107 H St E Poplar MT 59255-0000 |
| Phone Number | 4067683491 |
| Gender | M |
| Graduation Year | 2011 |
| Primary Specialty | GENERAL PRACTICE |
| Group Practice PAC ID | 9638081623 |
| Number of Group Practice Members | 92 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 271316 | FRANCES MAHON DEACONESS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 107 H St E, Poplar, MT 59255-0000 | 4067683491 | U S HEALTH DEPT OF HEALTH AND HUMAN SERVICES |
| Organization Legal Name | U S HEALTH DEPT OF HEALTH AND HUMAN SERVICES |
| Physicians | 121 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Pauline Elizabeth Powers-peprah | General Practice | U S Health Dept of Health and Human Services | Black Coal Dr Building, Suite 29, Fort Washakie, WY 82514-0128 |
| Luis A Rosa | Emergency Medicine | U S Health Dept of Health and Human Services | 760 Hospital Circle, Browning, MT 59417-0000 |
| Lawrence J Zazzo | General Practice | U S Health Dept of Health and Human Services | 550 6th S Ave, Wolf Point Health Center, Wolf Point, MT 59201-0000 |
| Ethel L Moore | Family Medicine | U S Health Dept of Health and Human Services | 669 Agency Main St, Harlem, MT 59526-9455 |
| Gregory J Wheeler | Clinical Psychologist | U S Health Dept of Health and Human Services | Black Coal Dr, Fort Washakie, WY 82514 |
| Erin E Neibauer | Nurse Practitioner | U S Health Dept of Health and Human Services | 212 Hwy I 90 Intersection, Crow Agency, MT 59022-9701 |
| Jerry L Foster | Nurse Practitioner | U S Health Dept of Health and Human Services | 107 H St E, Poplar, MT 59255-0000 |
| Thomas L Dolan | Optometry | U S Health Dept of Health and Human Services | 100 Cheyenne Ave, Lame Deer, MT 59043-0000 |
| Barbara S Cohn | Optometry | U S Health Dept of Health and Human Services | 10110 S 7650, Crow Agency, MT 59022-0009 |
| Karen A Nielson-salois | Clinical Psychologist | U S Health Dept of Health and Human Services | 760 Hospital Cir, Browning, MT 59417 |
| Street Address |
107 H ST E |
| City | POPLAR |
| State | MT |
| Zip | 59255-0000 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jerry L Foster | Nurse Practitioner | U S Health Dept of Health and Human Services | 107 H St E, Poplar, MT 59255-0000 |
| Karen E Kajiwara Nelson | Qualified Audiologist | U S Health Dept of Health and Human Services | 107 H St E, Poplar, MT 59255-0000 |
| Erin R Gockel | Nurse Practitioner | U S Health Dept of Health and Human Services | 107 H St E, Poplar, MT 59255-0000 |
| Anh T Pham | Optometry | U S Health Dept of Health and Human Services | 107 H St E, Poplar, MT 59255-0000 |
| Melissa A Kendall | Optometry | U S Health Dept of Health and Human Services | 107 H St E, Poplar, MT 59255-0000 |
| Lisa Sky Sun Rhodes | Family Medicine | U S Health Dept of Health and Human Services | 107 H St E, Poplar, MT 59255-0000 |
| Pat N Moran | Clinical Psychologist | U S Health Dept of Health and Human Services | 107 H St E, Poplar, MT 59255-0000 |
| Pierrette Toussaint | General Practice | U S Health Dept of Health and Human Services | 107 H St E, Poplar, MT 59255-0000 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Judith Ann Lauridsen | Nurse Practitioner | Riverside Family Clinic | 209 /2 H St E, Poplar, MT 59255-9519 |
| Nancy E Marston-quivey | Internal Medicine | Riverside Family Clinic | 209 /2 H St E, Poplar, MT 59255-9519 |
| Jimmy L Gray Jr. | Internal Medicine | Riverside Family Clinic | 209 /2 H St E, Poplar, MT 59255-9519 |
| Angela D St John | Nurse Practitioner | Riverside Family Clinic | 209 /2 H St E, Poplar, MT 59255-9519 |
| Abby L Reum | Nurse Practitioner | Riverside Family Clinic | 209 /2 H St E, Poplar, MT 59255-9519 |
| Jeremiah L Eldred | Nurse Practitioner | Riverside Family Clinic | 209 /2 H St E, Poplar, MT 59255-9519 |
| Stephanie Catron | Nurse Practitioner | Riverside Family Clinic | 209 /2 H St E, Poplar, MT 59255-9519 |
| City | POPLAR |
| Zip Code | 59255 |
| Specialty | GENERAL PRACTICE |
| City + Specialty | POPLAR + GENERAL PRACTICE |
Please comment or provide details below to improve the information on Wally Jean.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.