Jason R. Wallace, DO
Family Medicine · Pagosa Springs, CO
UnclaimedDONPI 1992020937
- Primary taxonomy
- 207Q00000X
- Enumerated
- 2010-04-01
- Practice location
- Pagosa Springs, CO
- Last NPPES update
- 2020-07-22
State licenses
- CO · Osteopathic physician · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.