Wallace, Roy Erickson

Wallace, Roy Erickson is an individual health care provider with primary practice located at 1 Jarrett White Rd Tamc, Personnel Division, Tamc HI 96859-5001. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Wallace, Roy Erickson can be contacted via phone (808) 433-1790.

Contact Information

Primary practice address
1 Jarrett White Rd Tamc, Personnel Division Tamc HI 96859-5001
Phone: (808) 433-1790
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1134191885
LBN Legal business name Wallace, Roy Erickson
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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