Dr. Tyson Wallace
Pharmacist
134 Bevill Ave, Gosnell
Arkansas, 72315
870-751-9242 870-751-9291
Dr. Tyson Wallace is a pharmacist in Gosnell, Arkansas. Patients can reach him at 134 Bevill Ave, Gosnell or contact him on 870-751-9242. Active license number of Dr. Tyson Wallace is PD09924 for Pharmacist in Arkansas.
Dr. Tyson Wallace is an individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
Complete Profile:
Dr. Tyson Wallace speciality, credentials, practice address, contact phone number and fax are as below. Patients can call on the below given phone number for enquiries.
| Name: | Dr. Tyson Wallace |
| Specialization: | Pharmacist |
| Credentials: | PHARM. D. |
| Gender: | Male |
| Location: | 134 Bevill Ave, Gosnell,
Arkansas, 72315 |
| Phone: | 870-751-9242 |
| Fax: | 870-751-9291 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of Dr. Tyson Wallace are as mentioned below.
| NPI Number: | 1982296877 |
| NPI Enumeration Date: | 11 Feb, 2021 |
| NPI Last Update On: | 22 Apr, 2025 |
Medical Licenses:
Pharmacists can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Tyson Wallace are as mentioned below.
| Specialization | License Number | State | Status | |
| Pharmacist | PD09924 | Arkansas | Primary | |
| Pharmacist | 2007005629 | Missouri | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Tyson Wallace such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 289547795 | Medicaid | Arkansas | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 134 Bevill Ave,
Gosnell, Arkansas |
| Zip: | 72315 |
| Phone Number: | 870-751-9242 |
| Fax Number: | 870-751-9291 |
Patients can reach Dr. Tyson Wallace at
134 Bevill Ave, Gosnell, Arkansas or can
call on phone at 870-751-9242.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.