Tyson Wallace, PHARM. D.

Pharmacist · Gosnell, AR

Individual Active NPI

NPI number 1982296877

Practice location

134 Bevill Ave
Gosnell, AR 72315
Phone
(870) 751-9242
Fax
(870) 751-9291

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NPI record

NPI
1982296877
Entity type
Individual (Type 1)
Enumeration date
February 11, 2021
Last updated
April 22, 2025
Certified
April 22, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pharmacist Primary 183500000X PD09924 AR
Pharmacist 183500000X 2007005629 MO

Other practice locations (1)

  • 339 E Commercial St, Senath, MO 63876-9238 · (573) 738-2097

About Dr. Wallace

Tyson Wallace, PHARM. D. is a healthcare provider registered in the NPI registry with the primary taxonomy Pharmacist (code 183500000X). The practice location is 134 Bevill Ave, Gosnell, AR 72315. The NPI number 1982296877 was assigned on February 11, 2021 and the record was last updated on April 22, 2025.

Dr. Wallace lists 2 licenses in the registry: #PD09924 (AR) for Pharmacist; #2007005629 (MO) for Pharmacist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Tyson Wallace, PHARM. D.?

The NPI number is 1982296877.

What is the phone number of Dr. Wallace?

The phone number listed for the practice location is (870) 751-9242.

Where is Dr. Wallace located?

134 Bevill Ave, Gosnell, AR 72315.

What is the taxonomy code for Dr. Wallace?

The primary taxonomy code is 183500000X – Pharmacist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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