Jeffrey S Wallis (NPI# 1528371507, PAC ID# 7416189279) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORAL SURGERY.
| Nation Provider ID (NPI) | 1528371507 |
| PAC ID by PECOS | 7416189279 |
| Professional Enrollment ID | I20150608000247 |
| Full Name | Jeffrey S Wallis |
| Organization Legal Name | ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES |
| Address |
2100 N Broad St Suite 106 Lansdale PA 19446-1052 |
| Phone Number | 2153688104 |
| Gender | M |
| Graduation Year | 2009 |
| Primary Specialty | ORAL SURGERY |
| Group Practice PAC ID | 7012990807 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 2100 N Broad St, Suite 106, Lansdale, PA 19446-1052 | 2153688104 | ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES |
| Organization Legal Name | ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nathan Anton Jarnot | Oral Surgery | Oral and Maxillofacial Surgical Associates | 303 Se1st St, Grand Rapids, MN 55744-3601 |
| Paul K Hodapp | Oral Surgery | Oral and Maxillofacial Surgical Associates | 3712 Tower Ave E, Superior, WI 54880-5398 |
| Scott K Varland | Oral Surgery | Oral and Maxillofacial Surgical Associates | 1000 E 1st St, Suite 108, Duluth, MN 55805-2297 |
| Michael A Sommer | Oral Surgery | Oral and Maxillofacial Surgical Associates | 2100 N Broad St, Suite 106, Lansdale, PA 19446-1052 |
| Richard P Deasy | Maxillofacial Surgery | Oral and Maxillofacial Surgical Associates | 2100 N Broad St, Suite 106, Lansdale, PA 19446-1052 |
| Bradley I Hersh | Oral Surgery | Oral and Maxillofacial Surgical Associates | 2100 N Broad St, Suite 106, Lansdale, PA 19446-1052 |
| Roger Spampata | Oral Surgery | Oral and Maxillofacial Surgical Associates | 2100 N Broad St, Suite 106, Lansdale, PA 19446-1052 |
| Stuart M Fredd | Oral Surgery | Oral and Maxillofacial Surgical Associates | 2100 N Broad St, Suite 106, Lansdale, PA 19446-1052 |
| Street Address |
2100 N BROAD ST SUITE 106 |
| City | LANSDALE |
| State | PA |
| Zip | 19446-1052 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Phu | General Surgery | Abington Memorial Hospital | 2100 N Broad St, North Penn Surgical Associates, Lansdale, PA 19446-1052 |
| Michael A Sommer | Oral Surgery | Oral and Maxillofacial Surgical Associates | 2100 N Broad St, Suite 106, Lansdale, PA 19446-1052 |
| Richard P Deasy | Maxillofacial Surgery | Oral and Maxillofacial Surgical Associates | 2100 N Broad St, Suite 106, Lansdale, PA 19446-1052 |
| Bradley I Hersh | Oral Surgery | Oral and Maxillofacial Surgical Associates | 2100 N Broad St, Suite 106, Lansdale, PA 19446-1052 |
| Roger Spampata | Oral Surgery | Oral and Maxillofacial Surgical Associates | 2100 N Broad St, Suite 106, Lansdale, PA 19446-1052 |
| Stuart M Fredd | Oral Surgery | Oral and Maxillofacial Surgical Associates | 2100 N Broad St, Suite 106, Lansdale, PA 19446-1052 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ann Marie T Storbrauck | Nurse Practitioner | Joseph Dantonio Md PC | 615 W Main St, Lansdale, PA 19446-0740 |
| Joseph Dantonio | Psychiatry | Joseph Dantonio Md PC | 615 W Main St, Lansdale, PA 19446-0740 |
| Douglas E Fry | Nurse Practitioner | Joseph Dantonio Md PC | 615 W Main St, Lansdale, PA 19446-0740 |
| Arnold Bierman | Optometry | 2302 N Broad St, Lansdale, PA 19446-0744 | |
| Mollie Rovnak | Nurse Practitioner | Detweiler Family Medicine and Asso | 1970 N Broad St, Lansdale, PA 19446-1002 |
| Michael T Parke | Family Medicine | Detweiler Family Medicine and Asso | 1970 N Broad St, Lansdale, PA 19446-1002 |
| Jaya Mehta | Family Medicine | Detweiler Family Medicine and Asso | 1970 N Broad St, Lansdale, PA 19446-1002 |
| Ryan Weaver | Chiropractic | Integrative Chiropractic Center | 1970 N Broad St, Lansdale, PA 19446-1002 |
| Evan Kessler | Family Medicine | Detweiler Family Medicine and Asso | 1970 N Broad St, Lansdale, PA 19446-1002 |
| Erin Shea | Nurse Practitioner | Detweiler Family Medicine and Asso | 1970 N Broad St, Lansdale, PA 19446-1002 |
| Find all physicians in zip 19446 | |||
| City | LANSDALE |
| Zip Code | 19446 |
| Specialty | ORAL SURGERY |
| City + Specialty | LANSDALE + ORAL SURGERY |
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| 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.