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Wallace Jackson Champlain, DO
Obstetrics & Gynecology Physician in Tahlequah, Oklahoma
NPI 1689648636

Wallace Jackson Champlain is a Obstetrics & Gynecology Physician based in Tahlequah, OK. Wallace Jackson Champlain practices in Tahlequah, OK and has the professional credentials of DO. The NPI Number for Wallace Jackson Champlain is 1689648636 and holds a License No. 1994 (Oklahoma).

The current practice location address for Wallace Jackson Champlain is 1500 E Downing St Ste 208, Tahlequah, OK and can be reached out via phone at 918-456-2496 and via fax at 918-456-7108.

Location: 1500 E Downing St Ste 208, Tahlequah, OK, 74464-3363
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1689648636
Provider Name
Wallace Jackson Champlain
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
1500 E Downing St Ste 208, Tahlequah, OK, 74464-3363
Phone Number
918-456-2496
Fax Number
918-456-7108
Provider Enumeration Date
02/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100118860A 05 OK
institution
Provider Business Practice Location Address Details
Address
1500 E Downing St Ste 208
City
Tahlequah
State
Oklahoma
Zip
74464-3234
Phone Number
918-456-2496
Fax Number
918-456-7108
person
Provider Business Mailing Address Details
Address
1500 E Downing St Ste 208
City
Tahlequah
State
Oklahoma
Zip
74464-3234
Phone Number
918-456-2496
Fax Number
918-456-7108
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
-
Taxonomy
207V00000X
License No.
1994 (Oklahoma)
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
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